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 3 Factors associated with daily heroin use and favoured route of administration 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	Daily use		Injected		Smoked		Snorted		Other
Variables	Categories	IRR	95% CI	IRR	95% CI	IRR	95% CI	IRR	95% CI	IRR	95% CI
Year	2011	1.11	[1.00–1.24]	0.89*	[0.80–0.98]	0.97	[0.89–1.07]	1.00	[0.95–1.05]	0.36***	[0.27–0.48]
	2012	0.98	[0.73–1.31]	0.82***	[0.74–0.90]	0.83**	[0.74–0.94]	0.92**	[0.87–0.98]	0.47***	[0.37–0.60]
	2013	0.91	[0.67–1.24]	0.76***	[0.69–0.85]	0.86*	[0.75–0.98]	0.86***	[0.80–0.92]	1.13	[0.92–1.38]
	2014	1.27**	[1.07–1.51]	0.62***	[0.55–0.71]	0.70***	[0.58–0.83]	0.78***	[0.69–0.87]	0.89	[0.67–1.17]
	2015	1.26*	[1.04–1.53]	0.66***	[0.58–0.75]	0.77*	[0.63–0.94]	0.77***	[0.69–0.86]	1.03	[0.74–1.42]
	2016	1.29*	[1.04–1.59]	0.64***	[0.56–0.73]	0.94	[0.78–1.13]	0.82***	[0.74–0.90]	0.68**	[0.51–0.90]
	2017	1.25*	[1.01–1.56]	0.62***	[0.54–0.72]	0.86	[0.71–1.04]	0.79***	[0.71–0.88]	0.71*	[0.54–0.94]
	2018	1.38*	[1.07–1.79]	0.61***	[0.53–0.70]	0.92	[0.76–1.11]	0.78***	[0.70–0.87]	0.70*	[0.52–0.92]
	2019	1.46**	[1.12–1.90]	0.54***	[0.46–0.63]	0.94	[0.75–1.17]	0.78***	[0.71–0.86]	0.84	[0.62–1.14]
	2020	1.22	[0.94–1.58]	0.47***	[0.39–0.57]	0.86	[0.68–1.08]	0.73***	[0.65–0.83]	0.92	[0.69–1.23]
Gender	Females	0.86***	[0.81–0.91]	0.87***	[0.83–0.92]	0.98	[0.93–1.04]	1.07***	[1.04–1.10]	0.99	[0.91–1.07]
Age	15–24	1.00	[0.87–1.14]	0.98	[0.88–1.10]	1.46***	[1.30–1.64]	1.38***	[1.31–1.45]	0.93	[0.80–1.08]
Age	25–34	1.01	[0.93–1.10]	0.89***	[0.83–0.95]	1.30***	[1.19–1.42]	1.23***	[1.19–1.26]	1.00	[0.93–1.08]
Job status	Unemployed	1.08	[0.99–1.18]	0.95	[0.89–1.01]	1.17***	[1.08–1.27]	1.25***	[1.21–1.29]	1.07	[0.96–1.19]
Job status	Working	0.87***	[0.80–0.95]	0.83***	[0.78–0.90]	1.29***	[1.20–1.39]	1.40***	[1.35–1.45]	0.98	[0.88–1.09]
Housing	Homeless/temporary accommodation	0.91**	[0.86–0.97]	0.87***	[0.82–0.91]	0.97	[0.92–1.02]	1.09***	[1.06–1.12]	0.79***	[0.72–0.86]
Housing	Paris metropolitan region	0.85	[0.62–1.18]	1.10	[0.90–1.36]	0.85	[0.67–1.07]	0.58***	[0.46–0.72]	0.85	[0.59–1.24]
OST—type	Methadone	0.96	[0.82–1.12]	1.46***	[1.30–1.63]	1.02	[0.88–1.18]	0.97	[0.91–1.03]	1.42***	[1.22–1.65]
OST—type	Other type	0.62	[0.31–1.24]	0.97	[0.47–1.97]	0.72	[0.39–1.31]	0.45	[0.20–1.02]	0.85	[0.42–1.71]
OST—time elapsed since onset	1 year or less	1.09**	[1.03–1.14]	0.92***	[0.88–0.96]	1.17***	[1.12–1.23]	1.14***	[1.11–1.18]	0.96	[0.88–1.04]
OST—time elapsed since onset	2–4 years	1.13**	[1.05–1.21]	0.93*	[0.87–0.99]	1.30***	[1.21–1.39]	1.26***	[1.20–1.31]	1.04	[0.93–1.15]
Licit substances	Yes	1.02	[0.94–1.12]	1.29***	[1.22–1.37]	1.17**	[1.05–1.30]	1.27***	[1.21–1.34]	0.84*	[0.74–0.96]
Illicit substances	Yes	2.43***	[2.19–2.69]	1.38***	[1.28–1.49]	0.98	[0.90–1.07]	0.98	[0.93–1.04]	0.53***	[0.46–0.60]
Psychotropics	Yes	1.05	[0.91–1.22]	1.07	[0.97–1.18]	0.75***	[0.66–0.85]	0.71***	[0.66–0.77]	1.00	[0.84–1.18]
Year × OMT	2011 × methadone	0.92	[0.80–1.06]	1.11*	[1.01–1.23]	1.10	[0.93–1.30]	1.04	[0.99–1.10]	2.08***	[1.60–2.72]
	2011 × Other	1.05	[0.55–2.00]	1.21	[0.76–1.92]	1.34	[0.86–2.07]	1.38	[0.83–2.32]	0.59	[0.22–1.59]
	2012 × methadone	0.78	[0.59–1.02]	1.08	[0.97–1.21]	1.46*	[1.04–2.04]	1.13***	[1.05–1.21]	1.51*	[1.05–2.18]
	2012 × Other	0.91	[0.37–2.23]	1.25	[0.71–2.23]	0.79	[0.35–1.80]	1.41	[0.74–2.71]	1.17	[0.47–2.91]
	2013 × methadone	0.85	[0.66–1.11]	1.04	[0.93–1.16]	1.09	[0.95–1.27]	1.12**	[1.04–1.20]	0.96	[0.79–1.16]
	2013 × Other	1.16	[0.43–3.09]	0.97	[0.54–1.74]	0.66	[0.30–1.47]	1.27	[0.78–2.06]	0.25	[0.05–1.31]
	2014 × methadone	1.01	[0.85–1.19]	1.10	[0.97–1.25]	1.28**	[1.10–1.49]	1.15**	[1.06–1.25]	1.05	[0.87–1.28]
	2014 × Other	0.90	[0.40–2.00]	1.32	[0.71–2.47]	1.06	[0.53–2.10]	1.69	[0.99–2.91]	0.93	[0.41–2.09]
	2015 × methadone	0.96	[0.81–1.14]	1.04	[0.91–1.19]	1.23*	[1.04–1.45]	1.22***	[1.12–1.32]	0.93	[0.76–1.14]
	2015 × Other	1.07	[0.50–2.28]	0.85	[0.44–1.62]	0.98	[0.47–2.04]	1.15	[0.54–2.45]	0.50	[0.21–1.21]
	2016 × methadone	0.92	[0.77–1.10]	1.08	[0.93–1.26]	1.16	[0.98–1.38]	1.25***	[1.15–1.35]	1.01	[0.82–1.25]
	2016 × Other	0.92	[0.44–1.92]	0.94	[0.51–1.73]	0.86	[0.43–1.68]	0.92	[0.43–1.98]	0.58	[0.24–1.41]
	2017 × methadone	0.91	[0.77–1.09]	1.04	[0.88–1.23]	1.35***	[1.14–1.60]	1.26***	[1.16–1.37]	0.97	[0.79–1.19]
	2017 × Other	1.08	[0.50–2.36]	0.79	[0.37–1.69]	0.99	[0.49–1.98]	1.24	[0.52–2.98]	0.64	[0.23–1.80]
	2018 × methadone	0.98	[0.83–1.17]	1.01	[0.87–1.18]	1.36***	[1.15–1.60]	1.24***	[1.14–1.35]	0.90	[0.72–1.12]
	2018 × Other	1.08	[0.49–2.37]	0.96	[0.43–2.11]	0.86	[0.41–1.79]	0.99	[0.40–2.44]	0.44	[0.15–1.28]
	2019 × methadone	0.98	[0.83–1.17]	1.10	[0.93–1.30]	1.35***	[1.13–1.61]	1.32***	[1.22–1.44]	0.77*	[0.61–0.98]
	2019 × Other	1.43	[0.68–3.00]	1.07	[0.49–2.35]	0.75	[0.36–1.56]	1.02	[0.43–2.44]	0.29*	[0.09–0.96]
	2020 × methadone	1.11	[0.92–1.35]	1.09	[0.92–1.30]	1.46***	[1.23–1.75]	1.34***	[1.23–1.46]	0.92	[0.71–1.18]
	2020 × Other	1.49	[0.70–3.15]	1.07	[0.50–2.29]	0.72	[0.30–1.73]	1.03	[0.45–2.33]	0.69	[0.29–1.62]
	var(_cons[idstr])	2.51***	[2.10–2.99]	1.68***	[1.52–1.85]	2.40***	[2.03–2.83]	1.74***	[1.57–1.93]	3.75***	[2.95–4.77]
	N	344,754		344,754		344,754		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. 58 individuals were discarded due to missing information
*p < 0.05; **p < 0.01; and ***p < 0.001

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