PMID- 30245459 OWN - NLM STAT- MEDLINE DCOM- 20190221 LR - 20231004 IS - 1879-0046 (Electronic) IS - 0376-8716 (Print) IS - 0376-8716 (Linking) VI - 192 DP - 2018 Nov 1 TI - Regular MDMA use is associated with decreased risk of drug injection among street-involved youth who use illicit drugs. PG - 112-117 LID - S0376-8716(18)30536-2 [pii] LID - 10.1016/j.drugalcdep.2018.07.035 [doi] AB - OBJECTIVES: Childhood trauma is common among street-involved youth and is associated with injection drug use. Illicit 3,4-Methylenedioxymethamphetamine (MDMA) use is also common among street-involved youth, and data suggest this substance has clinical utility in management of post-traumatic stress disorder (PTSD) and associated harms. Despite this, little is known about co-occurring patterns of MDMA use and injection drug use. METHODS: Data were derived from a prospective cohort of street-involved youth using illicit drugs in Vancouver, Canada. Using multivariable generalized estimating equation logistic regression, we examined the association between MDMA use and the use of injection drugs, adjusting for confounders such as polysubstance use and sociodemographic factors. RESULTS: 4941 surveys from 1208 participants between September 2005 and May 2015 were included. Of these, 829 (68.6%) were male, 815 (67.5%) reported white ethnicity, and median age was 21.7 years. Overall, 599 (49.6%) participants reported MDMA use, 544 (45.0%) reported injection drug use, and 244 (20.2%) reported concurrent MDMA and injection drug use at least once during the study period. In multivariable analyses, regular MDMA use was significantly negatively associated with injection drug use (Adjusted Odds Ratio [AOR] = 0.57, 95% CI: 0.46-0.69). DISCUSSION: After accounting for socio-demographic factors and polysubstance use, periods of reported regular MDMA use were negatively associated with reported injection drug use among this cohort. These findings suggest that, unlike the use of most other non-injection drugs, illicit MDMA use does not appear to promote injection drug use but rather is associated with a reduced likelihood of injection drug use. CI - Copyright (c) 2018 Elsevier B.V. All rights reserved. FAU - Gaddis, Andrew AU - Gaddis A AD - Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, 24016, USA; British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada. FAU - Lake, Stephanie AU - Lake S AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z9, Vancouver, BC, Canada. FAU - Tupper, Kenneth AU - Tupper K AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z9, Vancouver, BC, Canada. FAU - Nosova, Ekaterina AU - Nosova E AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada. FAU - Blommaert, Katrina AU - Blommaert K AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada. FAU - Wood, Evan AU - Wood E AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada. FAU - DeBeck, Kora AU - DeBeck K AD - British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, V5A 1S6, Burnaby, BC, Canada; School of Public Policy, Simon Fraser University, 515 W. Hastings St, V6B 5K3, Vancouver, BC, Canada. Electronic address: kora.debeck@bccsu.ubc.ca. LA - eng GR - U01 DA038886/DA/NIDA NIH HHS/United States GR - MOP-102742/CIHR/Canada PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20180912 PL - Ireland TA - Drug Alcohol Depend JT - Drug and alcohol dependence JID - 7513587 RN - 0 (Hallucinogens) RN - 0 (Illicit Drugs) RN - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine) SB - IM MH - Adolescent MH - Canada/epidemiology MH - Cohort Studies MH - Female MH - Hallucinogens/adverse effects MH - Homeless Youth/*psychology MH - Humans MH - Illicit Drugs/*adverse effects MH - Male MH - N-Methyl-3,4-methylenedioxyamphetamine/*adverse effects MH - Prospective Studies MH - Risk Reduction Behavior MH - Stress Disorders, Post-Traumatic/diagnosis/epidemiology/psychology MH - Substance-Related Disorders/diagnosis/*epidemiology/*psychology MH - Young Adult PMC - PMC6223257 MID - NIHMS1506471 OTO - NOTNLM OT - 3,4-Methylenedioxymethamphetamine (MDMA) OT - Childhood trauma OT - Ecstasy OT - Injection drug use OT - PTSD COIS- Conflict of Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. EDAT- 2018/09/25 06:00 MHDA- 2019/02/23 06:00 PMCR- 2019/11/01 CRDT- 2018/09/25 06:00 PHST- 2018/01/30 00:00 [received] PHST- 2018/07/16 00:00 [revised] PHST- 2018/07/17 00:00 [accepted] PHST- 2018/09/25 06:00 [pubmed] PHST- 2019/02/23 06:00 [medline] PHST- 2018/09/25 06:00 [entrez] PHST- 2019/11/01 00:00 [pmc-release] AID - S0376-8716(18)30536-2 [pii] AID - 10.1016/j.drugalcdep.2018.07.035 [doi] PST - ppublish SO - Drug Alcohol Depend. 2018 Nov 1;192:112-117. doi: 10.1016/j.drugalcdep.2018.07.035. Epub 2018 Sep 12.