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LatinX harm reduction capital, medication for opioid use disorder, and nonfatal overdose: A structural equation model analysis among people who use drugs in Massachusetts.
Shrestha, Shikhar; Stopka, Thomas J; Hughto, Jaclyn M W; Case, Patricia; Palacios, Wilson R; Reilly, Brittni; Green, Traci C.
Affiliation
  • Shrestha S; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States. Electronic address: shikhar.shrestha@tufts.edu.
  • Stopka TJ; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States.
  • Hughto JMW; Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States; Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States; Center for Health Promotion and Health Equity, Brown University, Providence, RI,
  • Case P; Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States.
  • Palacios WR; School of Criminology & Justice Studies, University of Massachusetts, Lowell, MA, United States.
  • Reilly B; Massachusetts Department of Public Health, Bureau of Substance Addiction Services, Boston, MA, United States.
  • Green TC; Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States; Opioid Policy Research Collaborative, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States; Department of Emergency Medicine, The Warren Alpert Medical Scho
Drug Alcohol Depend ; 259: 111293, 2024 Jun 01.
Article in En | MEDLINE | ID: mdl-38643530
ABSTRACT

BACKGROUND:

We introduce the concept of harm reduction capital (HRCap) as the combination of knowledge, resources, and skills related to substance use risk reduction, which we hypothesize to predict MOUD use and opioid overdose. In this study, we explored the interrelationships between ethnicity, HRCap, nonfatal overdose, and MOUD use among PWUD.

METHODS:

Between 2017 and 2019, people who currently or in the past used opioids and who lived in Massachusetts completed a one-time survey on substance use history, treatment experiences, and use of harm reduction services. We fit first-order measurement constructs for positive and negative HRCap (facilitators and barriers). We used generalized structural equation models to examine the inter-relationships of the latent constructs with LatinX self-identification, past year overdose, and current use of MOUD.

RESULTS:

HRCap barriers were positively associated with past-year overdose (b=2.6, p<0.05), and LatinX self-identification was inversely associated with HRCap facilitators (b=-0.49, p<0.05). There was no association between overdose in the past year and the current use of MOUD. LatinX self-identification was positively associated with last year methadone treatment (b=0.89, p<0.05) but negatively associated with last year buprenorphine treatment (b=-0.68, p<0.07). Latinx PWUD reported lower positive HRCap than white non-LatinX PWUD and had differential utilization of MOUD.

CONCLUSION:

Our findings indicate that a recent overdose was not associated with the current use of MOUD, highlighting a severe gap in treatment utilization among individuals at the highest risk. The concept of HRCap and its use in the model highlight substance use treatment differences, opportunities for intervention, and empowerment.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hispanic or Latino / Harm Reduction / Drug Overdose / Opioid-Related Disorders Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Drug Alcohol Depend Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hispanic or Latino / Harm Reduction / Drug Overdose / Opioid-Related Disorders Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Drug Alcohol Depend Year: 2024 Document type: Article