4.4 Article

Factors associated with methamphetamine withdrawal symptoms among people who inject drugs

Journal

DRUG AND ALCOHOL DEPENDENCE
Volume 223, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2021.108702

Keywords

Risk factors; Substance withdrawal syndrome/ prevention & control; Methamphetamine/adverse effects; HIV infections/complications; HCV infections/complications; Methamphetamine dependence/epidemiology

Funding

  1. National Institute on Drug Abuse of the National Institutes of Health [R01 DA038965, R01 DA046049, R01DA04604901A1S1]
  2. National Institute on Drug Abuse [R25DA035692]

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The study found that MA withdrawal symptoms are common among people who inject drugs and are associated with factors such as frequency of drug use and syringe sharing. The results suggest the need for strategies to implement treatment and service programs targeting individuals who inject MA.
Background: Regular methamphetamine (MA) use can result in withdrawal syndrome characterized by fatigue, agitation, depression, and anxiety. No studies that we are aware of have examined the prevalence and predictors of MA withdrawal symptoms among people who inject drugs (PWID). Methods: PWID were recruited using targeted sampling methods in Los Angeles and San Francisco, California from 2016 to 2017. Survey questions included demographics, drug use, and MA withdrawal symptoms, frequency, and symptom severity. Participants who reported regular MA use (>= 12 times in the last 30 days) were included in this analysis (N = 595). Multivariable regression models were developed to examine factors associated with any MA withdrawal, withdrawal frequency, symptom severity, and receptive syringe sharing. Results: MA withdrawal symptoms in the past 6 months were reported by 53 % of PWID, with 25 % reporting weekly withdrawal symptoms, and 20 % reporting very or extremely painful symptoms. In multivariable logistic regression, presence of any MA withdrawal symptoms was positively associated with more frequent MA use and non-injection tranquilizer use and inversely associated with crack cocaine use. Among those reporting any withdrawal, female sex was associated with more frequent withdrawal symptoms. Very or extremely painful withdrawal symptoms were associated with being in residential treatment. Receptive syringe sharing was associated with any MA withdrawal symptoms and weekly frequency of symptoms. Conclusion: MA withdrawal symptoms are common among PWID and are associated with receptive syringe sharing. Strategies for implementing MA use treatment, safe supply programs, and syringe services programs targeting people who inject MA are indicated.

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