Injection drug use cessation and use of North America's first medically supervised safer injecting facility.
BACKGROUND
Vancouver, Canada has a pilot supervised injecting facility (SIF), where individuals can inject pre-obtained drugs under the supervision of medical staff. There has been concern that the program may facilitate ongoing drug use and delay entry into addiction treatment.


METHODS
We used Cox regression to examine factors associated with the time to the cessation of injecting, for a minimum of 6 months, among a random sample of individuals recruited from within the Vancouver SIF. In further analyses, we evaluated the time to enrollment in addiction treatment.


RESULTS
Between December 2003 and June 2006, 1090 participants were recruited. In Cox regression, factors independently associated with drug use cessation included use of methadone maintenance therapy (Adjusted Hazard Ratio [AHR] = 1.57 [95% Confidence Interval [CI]: 1.02-2.40]) and other addiction treatment (AHR = 1.85 [95% CI: 1.06-3.24]). In subsequent analyses, factors independently associated with the initiation of addiction treatment included: regular SIF use at baseline (AHR = 1.33 [95% CI: 1.04-1.72]); having contact with the addiction counselor within the SIF (AHR = 1.54 [95% CI: 1.13-2.08]); and Aboriginal ancestry (AHR = 0.66 [95% CI: 0.47-0.92]).


CONCLUSIONS
While the role of addiction treatment in promoting injection cessation has been well described, these data indicate a potential role of SIF in promoting increased uptake of addiction treatment and subsequent injection cessation. The finding that Aboriginal persons were less likely to enroll in addiction treatment is consistent with prior reports and demonstrates the need for novel and culturally appropriate drug treatment approaches for this population.
DeBeck
Kora
K
BC Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
Kerr
Thomas
T
Bird
Lorna
L
Zhang
Ruth
R
Marsh
David
D
Tyndall
Mark
M
Montaner
Julio
J
Wood
Evan
E
D000328:Adult; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology; D016320:Substance Abuse Treatment Centers / Q000379:methods*; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000534:rehabilitation*; D013997:Time Factors
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