Evidence map›Paper›PMID 39175912›Full record

ArticleSubstance use : research and treatment

Behavioral and Health Outcome Differences by Heroin or Methamphetamine Preference Among People in Rural US Communities Who Use Both Substances.

L Sarah Mixson, Bridget M Whitney, Wiley D Jenkins, Thomas J Stopka, P Todd Korthuis, Lydia N Drumright, Stephanie A Ruderman, Peter D Friedmann, Mai T Pho, April M Young and 10 more

Abstract read
In one paragraph

Article in Substance use : research and treatment. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

L Sarah MixsonDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.ORCID https://orcid.org/0009-0006-5149-8859
Bridget M WhitneyDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Wiley D JenkinsDepartment of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA.
Thomas J StopkaDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
P Todd KorthuisDepartment of Medicine, Oregon Health & Science University, Portland, OR, USA.
Lydia N DrumrightDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Stephanie A RudermanDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Peter D FriedmannOffice of Research, UMass Chan Medical School - Baystate and Baystate Health, Springfield, MA, USA.
Mai T PhoBiological Sciences Division, University of Chicago, Chicago, IL, USA.
April M YoungDepartment of Epidemiology, University of Kentucky, Lexington, KY, USA.
Ryan P WestergaardDepartment of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
David W SealDepartment of Social, Behavioral, and Population Science Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Vivian F GoDepartment of Health Behavior, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
William C MillerDepartment of Epidemiology, University of North Carolina, Chapel Hill, Chapel Hill, NC, US.
William A ZuleDivision of Behavioral Health and Criminal Justice Research, RTI International, Research Triangle Park, NC, USA.
Judith FeinbergDepartment of Medicine, West Virginia University, Morgantown, WV, USA.
Hannah Lf CooperDepartment of Behavioral, Social, and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Judith I TsuiDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Heidi M CraneDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Joseph A DelaneyDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Funding

Ending transmission of HIV, HCV, and STDs and overdose in rural communities of people who inject drugs (ETHIC)UH3DA044829 · NIDA · UNIVERSITY OF CHICAGO · PI JENKINS, WILEY, PHO, MAI TUYET · 2019 to 2022
$5.2M
Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)UH3DA044798 · NIDA · UNIVERSITY OF KENTUCKY · PI COOPER, HANNAH LF, YOUNG, APRIL MARIE · 2019 to 2022
$4.4M
Oregon HIV/Hepatitis and Opioid Prevention and Engagement (OR-HOPE) Study Cost ExtensionUH3DA044831 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI KORTHUIS, PHILIP TODD · 2019 to 2022
$4.0M
Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE)UH3DA044830 · NIDA · BAYSTATE MEDICAL CENTER, INC. · PI FRIEDMANN, PETER D, STOPKA, THOMAS J · 2019 to 2022
$3.9M
Rural Comorbidity and HIV consequences of Opioid use Research and Treatment Initiative (Rural cohort)U24DA048538 · NIDA · UNIVERSITY OF WASHINGTON · PI CRANE, HEIDI M., TSUI, JUDITH · 2019 to 2023
$3.7M
Next-Generation Sequencing Center for GHOSTing Hepatitis C Virus: Transforming Community Based Molecular Surveillance and Outbreak InvestigationU24DA044801 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI ALLEN, TODD M · 2017 to 2022
$3.3M
Community-based, client-centered prevention homes to address the rural opioid epidemicUH3DA044826 · NIDA · UNIVERSITY OF WISCONSIN-MADISON · PI SEAL, DAVID W, WESTERGAARD, RYAN PATRICK · 2019 to 2022
$2.6M
Learning from the COVID-19 pandemic to improve emergency management planning for harm reduction services in rural OhioUH3DA044822 · NIDA · OHIO STATE UNIVERSITY · PI GO, VIVIAN F., MILLER, WILLIAM C · 2019 to 2022
$2.5M
Mitigating the Outcomes Associated with the Injection Drug Use Epidemic in Southern AppalachiaUH3DA044823 · NIDA · RESEARCH TRIANGLE INSTITUTE · PI ZULE, WILLIAM A · 2019 to 2021
$2.4M
Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE)UG3DA044830 · NIDA · BAYSTATE MEDICAL CENTER, INC. · PI FRIEDMANN, PETER D · 2017 to 2018
$1.6M
Community-based, client-centered prevention homes to address the rural opioid epidemicUG3DA044826 · NIDA · UNIVERSITY OF WISCONSIN-MADISON · PI SEAL, DAVID W, WESTERGAARD, RYAN PATRICK · 2017 to 2018
$1.4M
Kentucky Communities & Researchers Engaging to Halt the Opioid Epidemic-CARE2HOPEUG3DA044798 · NIDA · UNIVERSITY OF KENTUCKY · PI COOPER, HANNAH LF, YOUNG, APRIL MARIE · 2017 to 2018
$1.3M
NIDA NIH HHS U24 DA044801NIDA NIH HHS U24 DA048538NIDA NIH HHS UG3 DA044798NIDA NIH HHS UG3 DA044822NIDA NIH HHS UG3 DA044823NIDA NIH HHS UG3 DA044825NIDA NIH HHS UG3 DA044826NIDA NIH HHS UG3 DA044829NIDA NIH HHS UG3 DA044830NIDA NIH HHS UG3 DA044831NIDA NIH HHS UH3 DA044798NIDA NIH HHS UH3 DA044822NIDA NIH HHS UH3 DA044823NIDA NIH HHS UH3 DA044826NIDA NIH HHS UH3 DA044829NIDA NIH HHS UH3 DA044830NIDA NIH HHS UH3 DA044831
6 · The paper itself

Abstract

Background: The United States' (US) opioid overdose epidemic has evolved into a combined stimulant/opioid epidemic, a pattern driven in part by mitigating opioid overdose risk, variable substance availability, and personal preferences. This study aimed to investigate the association between self-reported substance preference (heroin or methamphetamine) and behavioral/health outcomes among individuals who used both heroin and methamphetamine in the rural US. Methods: The Rural Opioid Initiative is a consortium of 8 research cohorts from 10 states and 65 rural counties that recruited individuals reporting past 30-day injection of any substance or opioid substance use by any route from 1/2018 to 3/2020. Analyses were restricted to participants ⩾18 years, who self-reported either heroin or methamphetamine as their preferred substance and past 30-day use of both heroin and methamphetamine. We examined cross-sectional associations between preferred substance (heroin versus methamphetamine) and behavioral and health outcomes using random effects meta-analysis with adjusted regression models. Results: Among 1239 participants, 61% (n = 752) reported heroin as their preferred substance. Adjusting for age, sex, and race/ethnicity, methamphetamine preference was associated with lower prevalence ratios for current naloxone possession (adjusted prevalence ratio [aPR] = 0.68; 95% Confidence Interval [95% CI] = 0.59-0.78; Conclusion: In our study analyzing associations between preferred substance and various behavioral and health outcomes amongst people who use both heroin and methamphetamine, a majority of participants preferred heroin. Methamphetamine preference was associated with lower prevalence of naloxone possession, ever being told they had HCV, and prior history of an overdose. This study underscores the need for targeted harm reduction services for people who prefer methamphetamine in rural areas.

Indexed as

drug of choicedrug overdoseharm reductionHeroinmethamphetaminenaloxonepolysubstance userural population

Identifiers

PMID39175912
PMCPMC11339740

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.