title: Is the recent emergence of mephedrone injecting in the United Kingdom associated with elevated risk behaviours and blood borne virus infection?
abstract: The recent, and rapid, emergence of injection of the short-acting stimulant mephedrone (4-methylmethcathione) has resulted in concerns about increased infection risks among people who inject drugs (PWID). Data from the bio-behavioural surveillance of PWID in the United Kingdom were analysed to examine the impact of mephedrone injection on infections among PWID. During the year preceding the survey, 8.0% of PWID (163/2,047) had injected mephedrone. In multivariable analyses, those injecting mephedrone were younger, less likely to have injected opiates, and more likely to have injected cocaine or amphetamines, used needle/syringe programmes or sexual health clinics, been recruited in Wales and Northern Ireland or shared needles/syringes. There were no differences in sexual risks. Those injecting mephedrone more often had hepatitis C antibodies (adjusted odds ratio (AOR) = 1.51; 95% confidence interval (CI): 1.08-2.12), human immunodeficiency virus (AOR = 5.43; 95% CI: 1.90-15.5) and overdosed (AOR = 1.70; 95% CI: 1.12-2.57). There were no differences in the frequency of injecting site infections or prevalence of hepatitis B. The elevated levels of risk and infections are a concern considering its recent emergence. Mephedrone injection may currently be focused among higher-risk or more vulnerable groups. Targeted responses are needed to prevent an increase in harm.
authors.affiliation: Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom.
authors.forename: Vivian D
authors.initials: VD
authors.lastname: Hope
authors.forename: Katelyn J
authors.initials: KJ
authors.lastname: Cullen
authors.forename: Josie
authors.initials: J
authors.lastname: Smith
authors.forename: Lucy
authors.initials: L
authors.lastname: Jessop
authors.forename: John
authors.initials: J
authors.lastname: Parry
authors.forename: Fortune
authors.initials: F
authors.lastname: Ncube
mesh_terms: D000328:Adult; D017677:Age Distribution; D017848:Blood-Borne Pathogens; D015984:Causality; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000821:virology; D015897:Comorbidity; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous / Q000706:statistics & numerical data; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016485:Needle Sharing / Q000706:statistics & numerical data*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000821:virology; D006113:United Kingdom / Q000453:epidemiology; D014766:Viremia / Q000453:epidemiology* / Q000821:virology; D035862:Vulnerable Populations / Q000706:statistics & numerical data
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine; C548233:mephedrone
keywords: Hepatitis C; Mephedrone; People who inject drugs; human immunodeficiency virus - HIV; risk behaviours