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Canadian Journal of Public Health

, Volume 97, Issue 3, pp 166–170 | Cite as

Health and Social Services Accessed by a Cohort of Canadian Illicit Opioid Users Outside of Treatment

  • Lina NoëlEmail author
  • Benedikt Fischer
  • Mark W. Tyndall
  • Richard Bradet
  • Jürgen Rehm
  • Suzanne Brissette
  • Serge Brochu
  • Julie Bruneau
  • Nady El-Guebaly
  • T. Cameron Wild
Research

Abstract

Objective: To examine the use of social and health services by illicit opioid users outside of treatment in five Canadian cities (‘OPICAN’ cohort).

Methods: 677 eligible participants completed an interviewer-administered protocol and 584 supplied saliva samples for HIV and HCV antibody-testing. Chi-squared tests and multivariate analyses of variance (MANOVA) were carried out in order to determine the associations between use of services and specific factors. The explanatory variables of service utilization were determined with multiple regression analysis.

Results: The average age of respondents was 35 years, 66% were male and 68% were Caucasian. Women and HIV-positive individuals were more likely to receive health care. Participants who had a history of injection drug use, but had not injected within the previous 30 days, visited doctors more regularly and had a higher uptake of community-based services. Those who reported mental health problems used services less frequently than others. Participants recruited in Vancouver had more visits to needle exchange programs and centres specifically for women. Toronto participants were more likely to use homeless shelters and had a higher uptake of other types of community-based services.

Conclusion: Our study found a high rate of physical and mental health problems in illicit untreated opioid users in Canada, including the transmission of infectious disease. The availability of services seems to be a predictor of use of services. Setting up, adapting and evaluating front-line services tailored to illicit opioid users outside of treatment should be a policy and program priority.

MeSH terms

Illicit opioid use heroin use treatment health services social services comorbidity drug addiction HIV HCV 

Résumé

Objectif: Étudier l’utilisation des services sociaux et de santé par des consommateurs d’opiacés illicites ne suivant pas un traitement dans cinq villes canadiennes (cohorte OPICAN).

Méthode: Les 677 participants admissibles ont répondu à un questionnaire administré par un intervieweur, et 584 ont fourni un échantillon de salive pour le sérodiagnostic du VIH et du VHC. Des analyses du khi-carré et des analyses de variance à plusieurs variables ont été réalisées pour déterminer les liens entre l’utilisation des services et les différents indicateurs. Les variables explicatives de l’utilisation des services ont été déterminées au moyen d’analyses de régression multiple.

Résultats: L’âge moyen des répondants était de 35 ans, 66 % étaient des hommes, et 68 % étaient de race blanche. Les femmes et les personnes séropositives pour le VIH étaient plus susceptibles de recevoir des soins. Les utilisateurs et utilisatrices de drogues injectables qui ne s’étaient pas injectés au cours des 30 jours précédents consultaient plus régulièrement leur médecin et faisaient plus souvent appel aux services communautaires. Ceux qui déclaraient avoir un problème de santé mentale utilisaient les services moins régulièrement. Les participants recrutés à Vancouver avaient plus souvent fait appel à des programmes d’échange de seringues et à des centres pour femmes. Les participants de Toronto étaient plus susceptibles d’utiliser les refuges pour sans-abri et avaient davantage recours aux autres types de services communautaires.

Conclusion: Notre étude révèle un taux élevé, au Canada, de problèmes de santé physique et mentale, dont la transmission de maladies infectieuses, chez les consommateurs d’opiacés illicites ne suivant pas un traitement. La disponibilité des services semble être un prédicteur de leur utilisation. L’implantation, l’adaptation et l’évaluation de services de proximité conçus pour ces clients devraient constituer une priorité dans la formulation de politiques et de programmes.

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Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  • Lina Noël
    • 1
    Email author
  • Benedikt Fischer
    • 2
  • Mark W. Tyndall
    • 3
  • Richard Bradet
    • 4
  • Jürgen Rehm
    • 2
  • Suzanne Brissette
    • 5
  • Serge Brochu
    • 6
  • Julie Bruneau
    • 5
  • Nady El-Guebaly
    • 7
  • T. Cameron Wild
    • 8
  1. 1.Institut national de sante publique du QuébecBeauportCanada
  2. 2.University of Toronto and Centre for Addiction and Mental HealthTorontoCanada
  3. 3.BC Centre for Excellence in HIV/AIDSVancouverCanada
  4. 4.Unité de recherche en santé publique CRCHUL-CHUQCanada
  5. 5.Centre Hospitalier de l’Université de MontréalMontréalCanada
  6. 6.Centre international de criminologie comparéeUniversité de MontréalCanada
  7. 7.Foothills HospitalCalgaryCanada
  8. 8.Centre for Health Promotion StudiesUniversity of AlbertaCanada

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