Predictors of concurrent heroin use among patients on opioid maintenance treatment in France: a multilevel study over 11 years

Janssen, Eric; Vuolo, Mike; Spilka, Stanislas; Airagnes, Guillaume

doi:10.1186/s12954-024-00934-x

Harm Reduction Journal

Table 2 Factors associated with heroin use among patients with OMT in France 2010–2020

From: Predictors of concurrent heroin use among patients on opioid maintenance treatment in France: a multilevel study over 11 years

Variables	Categories	Model 1		Model 2
Variables	Categories	IRR	95% CI	IRR	95% CI
Year (Ref: 2010)	2011	0.99	[0.96–1.02]	0.95*	[0.91–0.99]
	2012	0.96*	[0.93–0.99]	0.90***	[0.86–0.94]
	2013	0.92***	[0.88–0.96]	0.89***	[0.85–0.94]
	2014	0.84***	[0.78–0.92]	0.79***	[0.73–0.87]
	2015	0.86***	[0.80–0.93]	0.82***	[0.75–0.89]
	2016	0.89**	[0.83–0.96]	0.84***	[0.78–0.91]
	2017	0.88***	[0.82–0.95]	0.83***	[0.76–0.89]
	2018	0.88***	[0.83–0.94]	0.83***	[0.77–0.89]
	2019	0.90**	[0.85–0.97]	0.82***	[0.76–0.89]
	2020	0.86***	[0.79–0.93]	0.77***	[0.70–0.85]
Gender (Ref: males)	Females	0.99**	[0.97–0.99]	0.99*	[0.97–1.00]
Age	15–24	1.19***	[1.15–1.23]	1.19***	[1.15–1.23]
(Ref: 35–64 y.o.)	25–34	1.11***	[1.09–1.13]	1.11***	[1.09–1.13]
Job status	Unemployed	1.12***	[1.09–1.14]	1.12***	[1.09–1.14]
(Ref: inactive)	Working	1.13***	[1.11–1.15]	1.13***	[1.10–1.15]
Housing (Ref: stable accommodation)	Homeless/temporary accommodation	0.98*	[0.97–1.00]	0.98*	[0.97–1.00]
Geographical location (Ref: Rest of the country)	Paris region	0.67***	[0.58–0.78]	0.67***	[0.58–0.78]
OMT—type	Methadone	1.18***	[1.15–1.21]	1.08**	[1.03–1.13]
(Ref: buprenorphine)	Other medication	0.64***	[0.51–0.79]	0.60	[0.33–1.12]
Time elapsed since onset	1 year or less	1.15***	[1.12–1.18]	1.15***	[1.12–1.18]
(Ref: 5 years or more)	2–4 years	1.08***	[1.06–1.10]	1.08***	[1.06–1.10]
Other substance use	Licit substances	1.19***	[1.15–1.22]	1.19***	[1.15–1.22]
(Ref: no use)	Illicit substances	1.22***	[1.17–1.27]	1.22***	[1.17–1.27]
(Ref: no use)	Psychotropics	0.86**	[0.83–0.89]	0.86**	[0.83–0.89]
Year × OMT	2011 × methadone			1.06***	[1.03–1.10]
	2011 × Other			1.27	[0.84–1.92]
	2012 × methadone			1.12***	[1.07–1.17]
	2012 × Other			1.18	[0.67–2.05]
	2013 × methadone			1.05*	[1.00–1.10]
	2013 × Other			0.96	[0.56–1.62]
	2014 × methadone			1.10***	[1.04–1.16]
	2014 × Other			1.34	[0.85–2.10]
	2015 × methadone			1.09***	[1.04–1.16]
	2015 × Other			1.01	[0.59–1.73]
	2016 × methadone			1.10***	[1.04–1.16]
	2016 × Other			0.91	[0.54–1.53]
	2017 × methadone			1.11***	[1.05–1.17]
	2017 × Other			1.05	[0.55–1.99]
	2018 × methadone			1.11***	[1.05–1.17]
	2018 × Other			0.95	[0.50–1.81]
	2019 × methadone			1.16***	[1.09–1.23]
	2019 × Other			1.05	[0.56–1.97]
	2020 × methadone			1.19***	[1.11–1.26]
	2020 × Other			1.02	[0.58–1.80]
var(cons[centres])		1.27***	[1.20–1.34]	1.27***	[1.20–1.34]
ICC/VPC		0.25		0.25
MMR		1.61	[1.52–1.69]	1.61	[1.52–1.69]
N		344,754		344,754

Source: RECAP survey
Licit substances include alcohol, tobacco and psychotropics under medical supervision. Illicit substances include other opioids, stimulants and hallucinogens. The category ‘Psychotropics’ refers to unprescribed use. ICC/VPC: intra-correlation coefficient/variance partitioning coefficient; MRR: Median rate ratio. 58 individuals were discarded due to missing information
*p < 0.05; **p < 0.01; and ***p < 0.001

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