Titre : | Trajectories of heroin use: 10-11-year findings from the Australian Treatment Outcome Study (2017) |
Auteurs : | M. TEESSON ; C. MAREL ; S. DARKE ; J. ROSS ; T. SLADE ; L. BURNS ; M. LYNSKEY ; S. MEMEDOVIC ; J. WHITE ; K. L. MILLS |
Type de document : | Article : Périodique |
Dans : | Addiction (Vol.112, n°6, June 2017) |
Article en page(s) : | 1056-1068 |
Langues: | Anglais |
Discipline : | EPI (Epidémiologie / Epidemiology) |
Mots-clés : |
Thésaurus géographique AUSTRALIEThésaurus mots-clés HEROINE ; TRAJECTOIRE ; ETUDE LONGITUDINALE ; FACTEUR PREDICTIF ; SANTE ; PSYCHOPATHOLOGIE ; SANTE MENTALE |
Résumé : |
Aims: To identify trajectories of heroin use in Australia, predictors of trajectory group membership and subsequent outcomes among people with heroin dependence over 10-11 years.
Design: Longitudinal cohort study. Setting: Sydney, Australia. Participants: A total of 615 participants were recruited between 2001 and 2002 as part of the Australian Treatment Outcome Study (66.2% male; mean age 29 years). The predominance of the cohort (87.0%) was recruited upon entry to treatment (maintenance therapies, detoxification and residential rehabilitation), and the remainder from non-treatment settings (e.g. needle and syringe programmes). This analysis focused upon 428 participants for whom data on heroin use were available over 10-11 years following study entry. Measurements: Structured interviews assessed demographics, treatment history, heroin and other drug use, overdose, criminal involvement, physical health and psychopathology. Group-based trajectory modelling was used to: (i) identify trajectory groups based on use of heroin in each year, (ii) examine predictors of group membership and (iii) examine associations between trajectory group membership and 10-11-year outcomes. Findings: Six trajectory groups were identified [Bayesian Information Criterion (BIC) = -1927.44 (n = 4708); -1901.07 (n = 428)]. One in five (22.1%) were classified as having 'no decrease' in heroin use, with the probability of using remaining high during the 10-11 years (> 0.98 probability of use in each year). One in six (16.1%) were classified as demonstrating a 'rapid decrease to maintained abstinence'. The probability of heroin use among this group declined steeply in the first 2-3 years and continued to be low ( Conclusions: Long-term trajectories of heroin use in Australia appear to show considerable heterogeneity during a decade of follow-up, with few risk factors predicting group membership. Just more than a fifth continued to use at high levels, while fewer than a fifth become abstinent early on and remained abstinent. The remainder showed fluctuating patterns. |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 52 |
Affiliation : | National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia |
Cote : | Abonnement |
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