title: Differences in polysubstance use patterns and drug-related outcomes between people who inject drugs receiving and not receiving opioid substitution therapies.
abstract: To test if polysubstance use profiles and drug-related outcomes differ between those receiving and not receiving opioid substitution therapies (OST) among people who inject drugs (PWID).
  
  
  
  An annual cross-sectional, sentinel sample of PWID across Australia.
  
  
  
  Data came from 3 years (2011-13) of the Illicit Drug Reporting System (IDRS).
  
  
  
  A total of 2673 participants who injected drugs from the combined national IDRS samples of 2011 (n = 868), 2012 (n = 922) and 2013 (n = 883).
  
  
  
  Latent class analysis (LCA) was used to summarize participants' self-reported use of 18 types of substances, with the resulting polysubstance use profiles then associated with participant experience of a number of drug-related outcomes.
  
  
  
  Polysubstance use profiles exhibiting a broad range of substance use were generally at increased risk of negative drug-related outcomes, whether or not participants were receiving OST, including thrombosis among OST receivers [odds ratio (OR) = 2.13, 95% confidence intervals (CI) = 1.09-4.17], injecting with used needles among OST receivers and non-receivers, respectively (OR = 2.78, 95% CI = 1.50-5.13; OR = 2.15, 95% CI = 1.34-3.45) and violent criminal offences among OST receivers and non-receivers, respectively (OR =2.30, 95% CI = 1.16-4.58; OR = 1.87, 95% CI = 1.14-3.07). An important exception was non-fatal overdose which was related specifically to a class of PWID who were not receiving OST and used morphine frequently (OR = 1.83, 95% CI = 1.06-3.17) CONCLUSION: Regardless of opioid substitution therapies usage, people who inject drugs who use a broad-range of substances experience greater levels of injecting-related injuries and poorer health outcomes and are more likely to engage in criminal activity than other groups of people who inject drugs.
authors: School of Population Health, The University of Queensland, Herston, QLD, Australia.
authors: Kim S
authors: KS
authors: Betts
authors: Centre for Youth Substance Abuse, University of Queensland, Brisbane, QLD, Australia.
authors: Gary
authors: G
authors: Chan
authors: QADREC, School of Population Health Building, University of Queensland, Brisbane, QLD, Australia.
authors: Fairlie
authors: F
authors: McIlwraith
authors: MacFarlane Burnet Institute for Medical and Public Health Research, Melbourne, VIC, Australia.
authors: Paul
authors: P
authors: Dietze
authors: National Drug and Alcohol Centre, University of New South Wales, NSW, Australia.
authors: Elizabeth
authors: E
authors: Whittaker
authors: National Drug and Alcohol Centre, University of New South Wales, NSW, Australia.
authors: Lucy
authors: L
authors: Burns
authors: School of Public Health and Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia.
authors: Rosa
authors: R
authors: Alati
mesh_terms: D000038:Abscess / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D002047:Buprenorphine / Q000627:therapeutic use; D000069479:Buprenorphine, Naloxone Drug Combination / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000453:epidemiology*; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data*; D016017:Odds Ratio; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000069479:Buprenorphine, Naloxone Drug Combination; D002047:Buprenorphine; D008691:Methadone
keywords: Drug treatment; latent class analysis; polysubstance use