Abstract
Objectives
This study sought to document the trends in drug use among intravenous drug users (IDUs) in northern British Columbia, and to discuss the public health implications.
Objectives
This study sought to document the trends in drug use among intravenous drug users (IDUs) in northern British Columbia, and to discuss the public health implications.
Method
We conducted a 7-year medical-chart review of all IDU-related admissions (n=2072) to an inpatient alcohol and drug detoxification centre in Prince George, British Columbia. Primary detoxification diagnosis was modeled onto year of admission using generalized estimating equations (GEE).
Results
Our study demonstrated an increasing prevalence of cocaine as the primary detoxification diagnosis in IDU-related admissions in northern BC, from 32% of all IDU admissions in 1999 to 64% in 2001, and then a relatively steady elevated rate of approximately 60% between 2001–2005.
Conclusions
Given that needle exchange programs and other harm reduction services for IDUs in British Columbia are not readily available in many northern and rural areas, the risks associated with intravenous cocaine use among northern IDUs represent a serious public health challenge. Tailored harm reduction strategies should take into account the prominence of intravenous cocaine use as an HIV risk factor. In areas without well-established intravenous drug use monitoring programs, such as rural and remote areas, detoxification treatment records may serve as important sentinels for changing drug use patterns among IDUs.
Key words: Substance abuse, intravenous; cocaine; rural health services; treatment centers, substance abuse
Résumé
Objectifs
Notre étude visait à documenter les tendances de la consommation de drogue chez les utilisateurs de drogue injectable (UDI) dans le Nord de la Colombie-Britannique et à examiner leurs conséquences pour la santé publique.
Méthode
Nous avons examiné les fiches médicales sur 7 ans de toutes les hospitalisations d’UDI (n=2 072) dans un centre de désintoxication de Prince George (Colombie-Britannique). Le principal diagnostic de désintoxication a été modélisé sur l’année d’hospitalisation à l’aide d’équations d’estimation généralisées (EEG).
Résultats
L’étude a montré une prévalence croissante de l’abus de cocaïne comme principal diagnostic de désintoxication dans les hospitalisations liées à l’utilisation de drogues injectables du Nord de la Colombie-Britannique; ce diagnostic est passé de 32% des hospitalisations d’UDI en 1999 à 64% en 2001, puis il s’est stabilisé à un niveau relativement élevé (environ 60%) entre 2001 et 2005.
Conclusion
Étant donné que les programmes d’échange de seringues et autres services de réduction des méfaits destinés aux UDI en Colombie-Britannique ne sont pas aisément accessibles dans de nombreuses régions nordiques et rurales, les risques associés à l’injection de cocaïne chez les UDI du Nord présentent un défi de taille pour la santé publique. Les stratégies de réduction des méfaits adaptées doivent tenir compte de la prédominance de la consommation de cocaïne par voie intraveineuse comme facteur de risque du VIH. Dans les secteurs qui n’ont pas de programmes établis pour la surveillance de l’utilisation de drogues injectables, les régions rurales et éloignées par exemple, les dossiers des centres de désintoxication peuvent être d’importantes sentinelles des changements dans les habitudes de consommation de drogue des UDI.
Mots clés: abus de drogues intraveineuses, cocaïne, services de santé ruraux, centres de désintoxication
Footnotes
Acknowledgements:The authors recognize that undertaking inpatient detoxification requires strength of spirit and courage, and we acknowledge the individuals who engaged in drug and/or alcohol withdrawal at the unit. We also thank the administrative staff at the treatment centre for all their hard work.
Funding: This study was funded by internal funds from the Centre for Addiction and Mental Health
References
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