title: Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors.
abstract: The association between needle exchange, change in drug use frequency and enrollment and retention in methadone drug treatment was studied in a cohort of Seattle injection drug users (IDUs). Participants included IDUs classified according to whether they had used a needle exchange by study enrollment and during the 12-month follow-up period. The relative risk (RR) and the adjusted RR (ARR) were estimated as measures of the association. It was found that IDUs who had formerly been exchange users were more likely than never-exchangers to report a substantial (> or= 75%) reduction in injection (ARR = 2.85, 95% confidence limit [CL] 1.47-5.51), to stop injecting altogether (ARR = 3.5, 95% CL 2.1-5.9), and to remain in drug treatment. New users of the exchange were five times more likely to enter drug treatment than never-exchangers. We conclude that reduced drug use and increased drug treatment enrollment associated with needle exchange participation may have many public health benefits, including prevention of blood-borne viral transmission.
authors.affiliation: Public Health, Seattle King County, 106 Prefontaine Place South, Seattle, WA 98104, USA. holly.hagan@metrokc.gov
authors.forename: H
authors.initials: H
authors.lastname: Hagan
authors.forename: J P
authors.initials: JP
authors.lastname: McGough
authors.forename: H
authors.initials: H
authors.lastname: Thiede
authors.forename: S
authors.initials: S
authors.lastname: Hopkins
authors.forename: J
authors.initials: J
authors.lastname: Duchin
authors.forename: E R
authors.initials: ER
authors.lastname: Alexander
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D015994:Incidence; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000534:rehabilitation; D014861:Washington / Q000453:epidemiology
chemical_list: D008691:Methadone