title: The Cedar Project: methadone maintenance treatment among young Aboriginal people who use opioids in two Canadian cities.
abstract: OBJECTIVE
  The Cedar Project is a community-based study aiming to identify variables associated with ever being on methadone maintenance treatment (MMT) among young Aboriginal people using drugs and to discuss possible barriers to MMT in this population.
  
  
  METHODS
  This is a prospective cohort study with recruitment by health-care providers, outreach, and word of mouth in Vancouver and Prince George. Participants included 605 Aboriginal participants who were age 14-30 years, reported illicit drug use in the month prior to enrolment, and provided written informed consent. Variables associated with ever being on MMT were analysed through χ(2) -testing and multivariate logistic regression, limited to people reporting opioid use (n = 397).
  
  
  RESULTS
  Less than half of participants reporting daily injection of opioids had ever been on MMT. In adjusted multivariate logistic regression analyses, older age [odds ratio (OR) 1.17; 95% confidence interval (CI) 1.08-1.28)]; female gender (OR 3.76; 95% CI 2.00-7.07); hepatitis C antibody positivity (OR 2.76; 95% CI 1.53-4.95); and daily opioid injection (OR 2.59; 95% CI 1.46-4.61) were positively associated with ever being on MMT. Weekly or more alcohol use (OR 0.43; 95% CI 0.21-0.87) was negatively associated with ever being on MMT.
  
  
  CONCLUSIONS
  MMT access by young Aboriginal people is low. The associations between MMT use and other variables need further study to steer efforts directed at recruitment into MMT. The removal of barriers to MMT and inclusion of young Aboriginal people in the development of treatment programs based on Indigenous values are urgently required to help Aboriginal people who use drugs.
authors.affiliation: Pender Community Health Centre, Vancouver, Canada.
authors.forename: Jerome
authors.initials: J
authors.lastname: Yang
authors.forename: Eugenia
authors.initials: E
authors.lastname: Oviedo-Joekes
authors.forename: Kukpi Wayne M
authors.initials: KW
authors.lastname: Christian
authors.forename: Kathy
authors.initials: K
authors.lastname: Li
authors.forename: Mabel
authors.initials: M
authors.lastname: Louie
authors.forename: Martin
authors.initials: M
authors.lastname: Schechter
authors.forename: Patricia
authors.initials: P
authors.lastname: Spittal
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000208:ethnology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000208:ethnology / Q000534:rehabilitation*; D011446:Prospective Studies
chemical_list: D009294:Narcotics; D008691:Methadone