The Cedar Project: Methadone maintenance treatment among young Aboriginal people who use opioids in two Canadian cities

Authors

  • JEROME YANG,

    1. Pender Community Health Centre, Vancouver, Canada
    Search for more papers by this author
  • EUGENIA OVIEDO-JOEKES,

    1. School of Population and Public Health, University of British Columbia, Vancouver, Canada
    2. Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
    Search for more papers by this author
  • KUKPI7 WAYNE M. CHRISTIAN,

    1. Splatsin—SEXQÉLTKEMC, Lakes Division of Secwepemc Nation, Enderby, Canada
    Search for more papers by this author
  • KATHY LI,

    1. Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
    Search for more papers by this author
  • MABEL LOUIE,

    1. Carrier Sekani Family Services, Vanderhoof, Canada
    Search for more papers by this author
  • MARTIN SCHECHTER,

    1. School of Population and Public Health, University of British Columbia, Vancouver, Canada
    2. Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
    Search for more papers by this author
  • PATRICIA SPITTAL

    Corresponding author
    1. School of Population and Public Health, University of British Columbia, Vancouver, Canada
    2. Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
      Dr Patricia Spittal, Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, 620B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. Tel: +1 604 806 8779; Fax: +1 604 806 8674; E-mail: spittal@mail.hivnet.ubc.ca
    Search for more papers by this author

  • Jerome Yang MD, CCFP, MHSc, Physician, Eugenia Oviedo-Joekes PhD, Assistant Professor, Kukpi7 Wayne M. Christian, Chief, Kathy Li PhD, Senior Research Associate, Mabel Louie, Health Director, Martin Schechter OBC, MD, PhD, FRSC, FCAHS, Professor, Patricia Spittal PhD, Professor.

Dr Patricia Spittal, Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, 620B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. Tel: +1 604 806 8779; Fax: +1 604 806 8674; E-mail: spittal@mail.hivnet.ubc.ca

Abstract

Introduction and Aims.The Cedar Project is a community-based study aiming to identify variables associated with ever being on methadone maintenance treatment (MMT) among young Aboriginal people using drugs and to discuss possible barriers to MMT in this population.

Design and Methods.This is a prospective cohort study with recruitment by health-care providers, outreach, and word of mouth in Vancouver and Prince George. Participants included 605 Aboriginal participants who were age 14–30 years, reported illicit drug use in the month prior to enrolment, and provided written informed consent. Variables associated with ever being on MMT were analysed through χ2-testing and multivariate logistic regression, limited to people reporting opioid use (n = 397).

Results.Less than half of participants reporting daily injection of opioids had ever been on MMT. In adjusted multivariate logistic regression analyses, older age [odds ratio (OR) 1.17; 95% confidence interval (CI) 1.08–1.28)]; female gender (OR 3.76; 95% CI 2.00–7.07); hepatitis C antibody positivity (OR 2.76; 95% CI 1.53–4.95); and daily opioid injection (OR 2.59; 95% CI 1.46–4.61) were positively associated with ever being on MMT. Weekly or more alcohol use (OR 0.43; 95% CI 0.21–0.87) was negatively associated with ever being on MMT.

Discussion and Conclusion.MMT access by young Aboriginal people is low. The associations between MMT use and other variables need further study to steer efforts directed at recruitment into MMT. The removal of barriers to MMT and inclusion of young Aboriginal people in the development of treatment programs based on Indigenous values are urgently required to help Aboriginal people who use drugs.[Yang J, Oviedo-Joekes E, Christian KWM, Li K, Louie M, Schechter M, Spittal P. The Cedar Project: Methadone maintenance treatment among young Aboriginal people who use opioids in two Canadian cities. Drug Alcohol Rev 2011;30:645–651]

Ancillary