Cessation of groin injecting behaviour among patients on oral opioid substitution treatment.
OBJECTIVE
To identify factors that might influence cessation of groin injecting (GI) among patients receiving oral opioid substitution treatment (OST).


METHODS
A cross-sectional survey.


METHODS
Drug treatment centres in South East England.


METHODS
Groin injectors (GIs) attending an ultrasound 'health-check' clinic.


METHODS
Clinical data and ultrasound images; comparing 65 patients who had injected drugs in the femoral vein (fv) in the previous month (current GIs) with 49 former groin injectors (former GIs).


RESULTS
Most of the 114 clinic attendees were men (69.3%) and white European (95.6%). Mean age, duration of GI and time in treatment were 36.4 years, 54.8 months and 20.5 months, respectively. Former GIs were significantly older (P < 0.001) and had been injecting (P < 0.05) and in treatment (P < 0.05) for longer than current GIs. History of deep vein thrombosis (DVT, P < 0.05) and septicaemia (P < 0.05); moderate/severe chronic venous disease (CVD, P < 0.01); and 'very severe' fv damage on ultrasonography (P < 0.05) were more common among former GIs. A logistic regression model correcting for the effects of covariants revealed age (B 0.08; Wald 7.1; P < 0.01) and severity of venous disease (B 1.1; Wald 4.1; P < 0.05) as the strongest predictors of behaviour change.


CONCLUSIONS
GI cessation is associated with longer time in treatment, increasing age and the presence of CVD and severely damaged fv. GI appears to be an intractable behaviour that often persists despite OST and severe health complications. Persistent GI should prompt a review of whether OST is optimized and whether other interventions are needed to promote behaviour change prior to the development of serious harm.
Senbanjo
Richard
R
Community Drug Services, KCA, Faversham, Kent, UK. rsenbanjo@kca.org.uk
Hunt
Neil
N
Strang
John
J
D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D006119:Groin; D006801:Humans; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
D009294:Narcotics; D008691:Methadone