Background

In the UK, legislation was implemented in 2014 allowing needle and syringe provision (NSP) services to offer foil to people who inject drugs (PWID) to encourage smoking rather than injecting. This paper aims to examine the association between foil uptake and smoking or snorting heroin among PWID. This is the first large scale national study to examine foil uptake and smoking or snorting heroin among PWID post legislative change.

Method

Data from 1453 PWID interviewed via Scotland's Needle Exchange Surveillance Initiative in 2017–2018 were analysed using multivariate logistic regression.

Results

Overall, 36% of PWID had obtained foil from NSP services in the past six months. The odds of smoking or snorting heroin were higher among those who had obtained foil (Adjusted Odds Ratio (AOR) 3.79 (95% CI 2.98–4.82) p<0.001) compared to those who had not. Smoking or snorting heroin was associated with lower odds of injecting four or more times daily (AOR 0.60 (95% CI 0.40–0.90) p = 0.012) and injecting into the groin or neck (AOR 0.57 (95% CI 0.46–0.71) p<0.001) but increased odds of having had a skin and soft tissue infection (SSTI) (AOR 1.49 (95% CI 1.17–1.89) p = 0.001) and having experienced an overdose (AOR 1.58 (95% CI 1.18–2.10) p = 0.002) both in the past year.

Conclusion

The promotion of smoking drugs via foil provision from NSP services may contribute to the package of harm reduction measures for PWID alongside the provision of injecting equipment. We found that those in receipt of foil were more likely to smoke or snort heroin, and that smoking or snorting heroin was associated with a lower likelihood of some risky injecting behaviours, namely frequent injecting and injecting into the groin or neck. But it remains uncertain if the provision of foil can lead to a reduction in health harms, such as SSTI and overdose. Future research is needed to understand PWID motivations for smoking drugs, obtaining foil from NSP services, and its uses particularly among polydrug users.

中文翻译：

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从针头和注射器提供服务中吸收箔纸及其在苏格兰注射吸毒者吸食或吸食海洛因中的作用

背景

在英国，2014 年实施了立法，允许针头和注射器提供 (NSP) 服务向注射吸毒者 (PWID) 提供箔纸，以鼓励吸烟而不是注射。本文旨在研究 PWID 中铝箔摄取与吸食或吸食海洛因之间的关联。这是第一项大规模的全国性研究，旨在检查 PWID 立法变更后吸食和吸食或吸食海洛因的情况。

方法

使用多元逻辑回归分析了 2017-2018 年通过苏格兰针头交换监测计划采访的 1453 名 PWID 的数据。

结果

总体而言，36% 的 PWID 在过去六个月中从 NSP 服务中获得了箔纸。与未获得箔片的人相比，获得箔片的人吸烟或吸食海洛因的几率更高（调整优势比 (AOR) 3.79 (95% CI 2.98–4.82) p <0.001）。吸烟或吸食海洛因与每天注射 4 次或更多次 (AOR 0.60 (95% CI 0.40–0.90) p  = 0.012) 和注射到腹股沟或颈部 (AOR 0.57 (95% CI 0.46–0.71) p <0.001) 但皮肤和软组织感染 (SSTI) (AOR 1.49 (95% CI 1.17–1.89) p  = 0.001) 和服药过量 (AOR 1.58 (95% CI 1.18–2.10) p  = 0.002) 都在过去一年。

结论

通过 NSP 服务提供的箔纸来推广吸烟药物可能有助于 PWID 的一揽子减少危害措施以及提供注射设备。我们发现那些收到箔纸的人更有可能吸食或吸食海洛因，吸食或吸食海洛因与一些危险注射行为的可能性较低有关，即频繁注射和注射到腹股沟或颈部。但是，提供箔纸是否可以减少健康危害，例如 SSTI 和过量服用，仍然不确定。未来的研究需要了解 PWID 吸毒的动机，从 NSP 服务获得箔纸，以及它在多药使用者中的用途。