Transition from first illegal drug use to first injection among people who inject drugs in Northern Mexico: A retrospective survival analysis
##plugins.themes.bootstrap3.article.main##
Abstract
Objective. We compare characteristics of the onset of drug use and first injection among people who inject drugs (PWID) from Ciudad Juárez and Hermosillo, two cities of Northern Mexico and identify factors associated with faster rates of transition from first drug use to the first injection.
Method. 841 PWID were interviewed in 2012 in Ciudad Juárez (n = 445) and Hermosillo (n = 396). Using lifetables, we describe timing at the onset of drug use and first injection. Cox regression analysis was used to determine factors associated with the transition hazard to first injection.
Results. Median age at onset of drug use was 15.5 years old (standard deviation [SD] = 5.73). The median age at first injection was 21.30 (SD = 7.22). The median duration-time between first drug use and transition to injection was 4.8 years (SD = 5.6). Controlling for sociodemographics, factors that increase the hazard of transitioning to injection are age at onset of drug use (adjusted-hazard-rate [AHR] = 1.04, 95% confidence-interval CI [1.03, 1.05], pp = .01), and having received assistance at first injection (AHR = 1.25, 95% CI [1.17, 1.33], p
Discussion and conclusion. Results show the need to enhance harm reduction programs among non-injecting drug users so as to prevent the spread of injecting drugs in Mexico.
References
Abelson, J., Treloar, C., Crawford, J., Kippax, S., Van Beek, I., & Howard, J. (2006) Some characteristics of early onset injection drug users prior to and at the time of their first injection. Addiction,101(4), 548-555. doi: 10.1111/j.1360-0443.2006.01379.x
Ambekar, A., Mishra, A., Parmar, A., Kumar, R., Kumar, M., Rao, R., & Agrawal, A. (2019) Are non-injecting opioid users at risk of transition to injecting drug use? A multi-site study from India. Asian Journal of Psychiatry, 42, 79-84. doi: 10.1016/j.ajp.2019.03.017
Arreola, S., Bluthenthal, R. N., Wenger, L., Chu, D., Thing, J., & Kral, A. H. (2014). Characteristics of people who initiate injection drug use later in life. Drug Alcohol Depend, 138, 244-250. doi: 10.1016/j.drugalcdep.2014.02.026
Astorga, L. (2016). El siglo de las drogas. Del porfiriato al nuevo milenio. Ciudad de Mexico: Debolsillo.
Baluku, M., Wamala, T., & Muhangi, D. (2019). HIV- and hepatitis C-related risk behaviors among people who inject drugs in Uganda: implications for policy and programming. Harm Reduction Journal, 16(1), 56. doi: 10.1186/s12954-019-0324-4
Bautista, S., Colchero, A., Sosa, S., & Conde, C. (2012). Diagnóstico situacional, mapeo de sitios de encuentro y evaluación de impacto de las estrategias de prevención de VIH/SIDA en México. Informe sobre la encuesta en sitios de encuentro de UDI. México: Fundación Mexicana para la Salud (Funsalud), Instituto Nacional de Salud Pública (INSP).
Ben Hamida, A., Rafful, C., Jain, S., Sun, S., Gonzalez-Zuniga, P., Rangel, G, … Werb, D. (2018). Non-injection Drug Use and Injection Initiation Assistance among People Who Inject Drugs in Tijuana, Mexico. Journal of Urban Health, 95(1), 83-90. doi: 10.1007/s11524-017-0188-4
Bloom, B. E., Jain, S., Sun, X., Garfein, R. S., Strathdee, S. A., Milloy, M.-J., … Rafful, C. (2021) Self-perception of assisting with future injection drug initiation: The influence of relationships in the process of drug injecting initiation. Drug and Alcohol Review, 40(1), 109-117. doi: 10.1111/dar.13145
Bluthenthal, R. N., Wenger, L., Chu, D., Bourgois, P., & Kral, A. H. (2017). Drug use generations and patterns of injection drug use: Birth cohort differences among people who inject drugs in Los Angeles and San Francisco, California. Drug and Alcohol Dependence, 175, 210-218. doi: 10.1016/j.drugalcdep.2017.04.001
Bourgois, P. (2003). Crack and the Political Economy of Social Suffering. Addiction Research & Theory, 11(1), 31-37. doi: 10.1080/1606635021000021322
Brecht, M.-L., Huang, D., Evans, E., & Hser, Y-I. (2008). Polydrug use and implications for longitudinal research: Ten-year trajectories for heroin, cocaine, and methamphetamine users. Drug and Alcohol Dependence, 96(3), 193-201. doi: 10.1016/j.drugalcdep.2008.01.021
Centro Nacional para la Prevención y Control del VIH y el sida (CENSIDA). (2010). Estimation of population size. Men who have sex with men and People who inject drugs in priority cities for project “Global Fund to Fight HIV, Tuberculosis, and Malaria Round 9”. Mexico City: Secretary of Health.
Centros de Integración Juvenil [CIJ], & Sistema de Información Epidemiológica del Consumo de Drogas [SIECD]. (2021). Droga de mayor impacto reportada por usuarios de drogas ilícitas solicitantes de tratamiento en Centros de Integración Juvenil del 2° semestre de 2004 al 2° semestre de 2020 (Nivel Nacional y Entidades Federativa). Ciudad de México: Centros de Integración Juvenil.
Cleves, M., Gutiérrez, R., Gould, W., & Marchenko, Y. (2010). An introduction to survival analysis using stata. Third Edition. Texas: Stata Press Publication.
Crofts, N., Louie, R., Rosenthal, D., & Jolley, D. (1996). The first hit: circumstances surrounding initiation into injecting. Addiction, 91(8), 1187-1196. doi: 10.1046/j.1360-0443.1996.918118710.x
Doherty, M. C., Garfein, R. S., Monterroso, E., Brown, D., & Vlahov, D. (2000). Correlates of HIV infection among young adult short-term injection drug users. AIDS, 14(6), 717-726. doi: 10.1097/00002030-200004140-00011
Fleiz-Bautista, C., Domínguez-García, M., Villatoro-Velázquez, J. A., Vázquez-Quiroz, F., Zafra-Mora, E., Sánchez-Ramos R., … Medina-Mora, M. E. (2019). Cuqueando la Chiva: Contextos del consumo de heroína en la frontera norte de México. Ciudad de México: INPRFM.
Fuller, C. M., Vlahov, D., Ompad, D. C., Shah, N., Arria, A., & Strathdee, S. A. (2002). High-risk behaviors associated with transition from illicit non-injection to injection drug use among adolescent and young adult drug users: a case-control study. Drug and Alcohol Dependence, 66(2), 189-198. doi: 10.1016/s0376-8716(01)00200-9
Garfein, R. S., Vlahov, D., Galai, N., Doherty, M. C., & Nelson, K. E. (1996). Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health, 86(5), 655-661. doi: 10.2105/ajph.86.5.655
Horyniak, D., Stoové, M., Degenhardt, L., Aitken, C., Kerr, T., & Dietze, P. (2015). How do drug market changes affect characteristics of injecting initiation and subsequent patterns of drug use? Findings from a cohort of regular heroin and methamphetamine injectors in Melbourne, Australia. Int JDrug Policy, 26(1), 43-50. doi: 10.1016/j.drugpo.2014.09.002
Hser, Y. (2007). Predicting long-term stable recovery from heroin addiction: Findings from a 33-year follow-up study. Journal of Addictive Diseases, 26(1), 51-60. doi: 10.1300/J069v26n01_07
Koozegar, M., Shahesmaeili, A., & Noroozi, M. (2018). Transition from First Drug Use to Regular Injection among People Who Inject Drugs in Iran. Addict Health, 10(1), 32-40. doi: 10.22122/ahj.v10i1.458
Ly, K. N., Xing, J., Klevens, R. M., Jiles, R. B.,Ward, J. W., & Holmberg, S. D. (2012). The increasing burden of mortality from viral hepatitis in the United States between 1999 and 2007. Ann Intern Med, 156(4), 271-278. doi: 10.7326/0003-4819-156-4-201202210-00004
Medel, M., Lu, Y., & Chow, E. (2015). Mexico’s drug networks: Modeling the smuggling routes towards the United States. Applied Geography, 60, 240-247. doi: 10.1016/j.apgeog.2014.10.018
Meyers, S. A., Rafful, C., Mittal, M. L., Smith, L. R., Tirado-Muñoz, J., Jain, S., … Scheim, A.I. (2021). Examining the gender composition of drug injecting initiation events: A mixed methods investigation of three North American contexts. International Journal of Drug Policy, 90, 103056. doi: 10.1016/j.drugpo.2020.103056
Mittal, M. L., Guise, A., Rafful, C., Gonzalez-Zuñiga, P., Davidson, P., Vashishtha, D., … Werb, D. (2019). “Another Person Was Going to Do It”: The Provision of Injection Drug Use Initiation Assistance in a High-Risk U.S.-Mexico Border Region. Substance Use & Misuse, 54(14), 2338-2350. doi: 10.1080/10826084.2019.1648514
Morris, M., Brouwer, K., Lozada, R., Gallardo, M., Vera, A., & Strathdee, S. (2012). “Injection First”: A Unique Group of Injection Drug Users in Tijuana, Mexico. American Journal on Addictions, 21(1), 23-30. doi: 10.1111/j.1521-0391.2011.00194.x
Neaigus, A., Miller, M., Friedman, S. R., Hagen, D. L., Sifaneck, S. J., Ildefonso, G., & Des Jarlais, D. C. (2001). Potential risk factors for the transition to injecting among non-injecting heroin users: a comparison of former injectors and never injectors. Addiction, 96(6), 847-860. doi: 10.1046/j.1360-0443.2001.9668476.x
Oliveira, M. L., Hacker, M. A., Nóbrega, S. A., Telles, P. R., Rodrigues, K. M., Yoshida, C. F. & Bastos, F. I. (2006). “The first shot”: The context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil. Cad Saude Publica, 22(4), 861-870. doi: 10.1590/s0102-311x2006000400024
Ospina-Escobar, A. (2016a). Discutiendo la hipótesis de la “puerta de entrada” del inicio del uso de drogas ilegales. Revista Internacional de Investigación en Adicciones, 2(2), 3-12. doi: 10.28931/riiad.2016.2.02
Ospina-Escobar, A. (2016b). Itinerarios de adversidad. Biografías de uso de drogas, estilos de vida y ambientes de riesgo al VIH en varones inyectores de Tijuana, Cd. Juárez y Hermosillo, México. Tesis de doctorado en Estudios de Población. Ciudad de México: El Colegio de México.
Ospina-Escobar, A. (2019). Changes in the Dynamics ofDrug Dealing and Use.A Generational Analysis for Hermosillo, Sonora. International Journal of Borders, Territories and Regions, 31(9), 1-25. doi: 10.33679/rfn.v1i1.2035
Ospina-Escobar, A., Magis-Rodríguez, C., Juárez, F., Werb, D., Bautista Arredondo, S., Díaz-Carreón, R., ... Strathdee, S. (2018). Comparing risk environments for HIV among people who inject drugs from three cities in Northern Mexico. Harm Reduction Journal, 15, 27. doi: 10.1186/s12954-018-0225-y
Pan American Health Organization [PAHO]. (2008). Encuestas de Comportamiento en Consumidores de Drogas con Alto Riesgo (CODAR). Herramientas básicas para vigilancia de segunda generación de la transmisión de VIH y otras ITS en CODAR. Retrieved from https://www3.paho.org/hq/index.php?option=com_content&view=article&id=853:2009-encuestas-comportamiento-consumidores-drogas-alto-riesgo-codar&Itemid=820&lang=en
Pressat, R. (2000). El análisis demográfico. Métodos, resultados, aplicaciones [The demographic analysisl. Methods, results and applications]. Mexico: Fondo de Cultura Económica.
Rafful, C., Jain, S., Sun, X., Strathdee, S. A., Garfein, R. S., Cuevas-Mota, J., … Werb, D. (2018). Identification of a Syndemic of Blood-Borne Disease Transmission and Injection Drug Use Initiation at the US-Mexico Border. Journal of Acquired Immune Deficiency Syndromes, 79(5), 559-565. doi: 10.1097/QAI.0000000000001858
Robertson, A., Lozada, R., Pollini, R., Rangel, G., & Ojeda, V. (2012) Correlates and contexts of US Injection Drug Initiation among undocumented mexican migrant who were deported from de United States. Aids Behavior, 16(6), 1670-1680. doi: 10.1007/s10461-011-0111-z
Roy, E., Haley, N., Leclerc, P., Cédras, L., Blais, L., & Boivin, J. F. (2003). Drug injection among street youths in Montreal: predictors of initiation. Journal of Urban Health, 80(1), 92-105. doi: 10.1093/jurban/jtg092
Secretaría de Salud, Subsecretaría de Prevención y Promoción de la Salud & Dirección General de Epidemiología. (2020). Sistema de Vigilancia Epidemiológica de las Adicciones (SISVEA) Informe 2017-2018. Ciudad de México. Retrieved from https://epidemiologia.salud.gob.mx/gobmx/salud/documentos/info_sisvea/informes_sisvea_2017-2018.pdf
Valenzuela, E., & Fernández, M. (2011). The Sequence of Drug Use: Testing the Gateway Hypothesis in Latin America. The Journal of International Drug, Alcohol and Tobacco Research, 1(1), 1-8.
Vidal-Trecan, G. M., Varescon-Pousson, I., & Boissonnas, A. (2002). Injection risk behaviors at the first and at the most recent injections among drug users. Drug and Alcohol Dependence, 66(2), 107-109. doi: 10.1016/S0376-8716(01)00196-X
Villatoro-Velázquez, J. A., Medina-Mora, M. E., Fleiz-Bautista, C., Téllez-Rojo, M. M., Mendoza-Alvarado, L. R., Romero-Martínez, M., … Alvear Sevilla, C. (2012) National Survey of Alcohol, Tobacco and Drug Use, 2011, Drugs Report. Mexico City: National Institute of Psychiatry Ramón de la Fuente Muñiz; National Institute of Public Health; Secretary of Health.
Villatoro-Velázquez, J. A., Resendiz-Escobar, E., Mujica-Salazar, A., Bretón-Cirett, M., Cañas-Martínez, V., Soto-Hernández, I., … Mendoza-Alvarado, L. (2017). National Survey of Alcohol, Tobbacco and Drug Use, 2016, Drugs Report. Mexico City: National Institute of Psychiatry Ramón de la Fuente Muñiz; National Institute of Public Health; Secretary of Health.
Vlahov, D., Fuller, C. M., Ompad, D. C., Galea, S., & Des Jarlais, D. C. (2004). Updating the infection risk reduction hierarchy: preventing transition into injection. Journal of Urban Health, 81(1), 14-19. doi: 10.1093/jurban/jth083
Vorobjov, S., Des Jarlais, D. C., Abel-Ollo, K., Talu, A., Rüütel, K., & Uusküla, A. (2013) Socio-demographic factors, health risks and harms associated with early initiation of injection among people who inject drugs in Tallinn, Estonia: Evidence from cross-sectional surveys. Int J Drug Policy, 24(2), 150-155. doi: 10.1016/j.drugpo.2012.08.003
Werb, D., Bluthenthal, R. N., Kolla, G., Strike, C., Kral, A. H., Uusküla, A., & Des Jarlais, D. (2018). Preventing injection drug use initiation: state of the evidence and opportunities for the future. J Urban Health, 95(1), 91-98. doi: 10.1007/s11524-017-0192-8
