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All relevant data can be found in the document and its supporting information files. An increase in the use of crystalline methamphetamine (“crystalline methamphetamine”) has been observed in North America and international jurisdictions, including a notable increase in the presence of methamphetamine in deaths due to illicit drug toxicity in british columbia (British Columbia), Canada. We used data from a cross-sectional survey and a urine toxicological test to report the prevalence, correlations, and validity of self-reported use of crystalline methamphetamine among clients at harm reduction sites in British Columbia. We used a two-stage convenience sampling approach to identify participating sites.
Regional harm reduction program coordinators helped identify suitable sites for participation in each of British Columbia's five health regions. The sites were then consulted and recruited based on willingness to participate and logistical capacity. The site's trained staff and volunteers were responsible for hiring participants and for managing. The sites were given two weeks to complete data collection.
A participant could report the use of more than one substance; therefore, the percentages in the columns can add up to more than 100%. B. Participants may indicate more than one route of administration, if appropriate. The percentages of rows for the route of administration are presented.
BP values reflect the importance of the Chi-square test or Fisher's exact test, where appropriate. C. Transgender and gender-expansive people include people who identified themselves as transgender men, transgender women, and gender non-conforming people. Participants who reported on crystalline methamphetamine use did not differ significantly in terms of geographic region or urbanity (Table).
Those who used crystalline methamphetamine were relatively younger than those who didn't (P). The majority of participants who reported using crystalline methamphetamine also reported using opioids in the past three days; opioid use was significantly higher among those who used crystalline methamphetamine compared to the rest of the participants (67.7% versus. First, it provides a comprehensive, contemporary and more generalizable estimate of crystalline methamphetamine use in British Columbia, based on previous work that has focused on young people and urban populations. Second, it provides evidence on usage patterns among all clients of harm reduction services, not limited to those who use opioids.
Third, it reports on the accuracy of the self-reported use of crystalline methamphetamine, which may be useful for doctors and patients when providing health services. As with all survey methods, the quality of the data is limited due to self-information and, since they are cross-sectional, we cannot evaluate causal associations. Limitations around the ability to remember were mitigated by asking about substance use and recent substance use patterns (three days), and the validity of self-reported use of crystalline methamphetamine for longer periods of withdrawal may differ. In addition, we did not have access to additional information about family history of substance use and the duration of substance use, which may be an important correlation to consider.
In addition, the interpretations of the current study are limited by the nature of the sample, which represents people who use substances who access harm reduction services, and it may not be generalized to the entire population of people who use substances in British Columbia and elsewhere. Crystalline methamphetamine is the most commonly used drug among harm reduction clients in British Columbia and its use has increased over time. Its use is very common among the homeless and is often closely related to opioid use, increasing the risk of overdose and other sequelae associated with multiple substance use. It is necessary to invest in harm reduction services and health services for the prevention and management of harm that may result from the use of crystalline methamphetamine, in addition to prospective epidemiological research to better understand consumption patterns, dependence and social and health outcomes.
The authors wish to express our gratitude to the participants, the staff of the harm reduction site and the regional harm reduction coordinators for participating in the study and for their tireless efforts at the forefront of community harm reduction work. We would like to recognize the contributions of Dr. Alexis Crabtree in survey development and administration. Finally, the authors would like to thank Dr.
Michael Otterstatter for his support in data analysis. The authors respectfully acknowledge that they live and work in the traditional unceded territories of the Salish peoples of the coast, including the traditional territories of the nations xmreash and sěli⁄ilwsetta (Tsleil-Waututh), and that the Harm Reduction Customer Survey was conducted in Traditional unceded territories of 198 First Nations. The author JAB is the principal investigator of the harm reduction client survey project, funded by Health Canada's Substance Use and Addiction Program (SUAP) (grant 1819-HQ-00005), and had full access to all study data and was ultimately responsible for the decision to submit it for publication. The components of this study were funded by the Canadian Institutes for Health Research (CIHR) (funding reference number 17028) and by the British Columbia Ministry of Health.
The author MK is supported by the Pierre Elliott Trudeau Foundation doctoral scholarship. The funders had no role in the study design, the collection and analysis of data, the decision to publish, or the preparation of the manuscript. To characterize recent use of crystalline methamphetamine, an analytical sample was obtained with complete answers for all demographic and substance use variables. In the current study, the prevalence of opioid and stimulant overdose in the past six months was higher among those who used crystalline methamphetamine compared to those who didn't.
Urine samples provided by a subgroup of participants were used to derive the validity of the three-day self-reported consumption of crystalline methamphetamine compared to toxicological urine tests. The validity measures of self-reported methamphetamine use over the past three days compared to the toxicological analysis of urine are provided in Table 4. The final analytical sample for evaluating factors associated with the use of crystalline methamphetamine was limited to 917 respondents, after excluding missing data for any of the predictor variables. Table 3 presents adjusted and unadjusted probabilities for factors associated with self-reported use of crystalline methamphetamine in the past three days.
The use of crystalline methamphetamine should be understood both within the context of opioid use and outside of opioid use, taking into account the harmful consequences that may arise. In addition to the problem of addiction, crystalline methamphetamine is cut with unknown chemicals, which are sometimes dangerous and deadly. Among the participants, 77% (n %3D) and 67% were detected methamphetamine in their urine (true prevalence) and 69.0% (n %3D) 60% reported using crystalline methamphetamine in the past three days (apparent prevalence). We compared self-reported methamphetamine use in the past three days with the detection of methamphetamine in urine toxicology tests for the subgroup of participants who participated in urinalysis.
Understanding the evolving patterns of substance use will be imperative to adapt harm reduction and substance use services to people who use crystalline methamphetamine. The objective of this study was to build on previous work to describe the epidemiology of crystalline methamphetamine use among people who use substances in British Columbia. In addition, two-thirds of those who had used treatment with opioid agonists in the past three days also reported using crystalline methamphetamine. .