Objective: To improve estimates of treatment demand, we developed a readiness-to-stop-drug-use model among injection drug users (IDUs) in Baltimore, a city with a treatment-on-request policy. Methods: IDUs enrolled in a prospective cohort study underwent semiannual questionnaires, including a readiness-to-stop-drug-use module based on Prochaska and DiClimente's stages of change. Scales distinguishing precontemplation, contemplation, and determination stages were developed using factor analysis. Construct validity was assessed in relation to attribution of specific problems to drug use, attitudes toward treatment, and perceived positive aspects of drug use. Logistic regression compared sociodemographics, drug use patterns, and treatment history. Results: Of 433 active IDUs, 17% were in precontemplation, 55% were in contemplation, and 28% were in determination. The majority were male (77%) and African American (93%). Mean age was 44 and the average injection career was 22 years. Persons in a later stage (more inclined to stop drug use) were more likely to associate specific problems with drug use and to have a positive attitude toward treatment. There was no difference among stages in perceived positive aspects of drug use. In multivariate analysis, later stage was associated with increased likelihood of speedball injection (AdjOR 2.1), having recently been in detoxification (AdjOR 2.8), and non-pneumocystis pneumonia (AdjOR 3.1). Data on the relationship between stage and self-reported treatment entry at 6-month followup will be presented. Conclusions: This study supports the validity of the stage of change model among IDUs. It underscores the importance of the availability of treatment as a factor in the decision to stop injection drug use.
Learning Objectives: At the conclusion of the presentation, the participant will be able to apply and evaluate a stage-of-change model to a population of injection drug users
Keywords: Drug Injectors, Treatment Patterns
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.