Retraso en el acceso al primer tratamiento para la adicción en usuarios de opiáceos Delay among opioid users in seeking first addiction treatment

Autores/as

  • Carlos Ortega Muela Departamento de Salud Pública y Materno-Infantil. Facultad de Medicina. Universidad Complutense de Madrid
  • María Rodríguez Mincholé Departamento de Salud Pública y Materno-Infantil. Facultad de Medicina. Universidad Complutense de Madrid
  • Marta Donat López Escuela Nacional de Sanidad, Instituto de Salud Carlos III; CIBER Epidemiología y Salud Pública (CIBERESP)
  • Jesús Henares Montiel Escuela Andaluza de Salud Pública; CIBER Epidemiología y Salud Pública (CIBERESP)
  • Raquel García-Page Fernández Departamento de Salud Pública y Materno-Infantil. Facultad de Medicina. Universidad Complutense de Madrid
  • María José Belza Egozcue Escuela Nacional de Sanidad, Instituto de Salud Carlos III; CIBER Epidemiología y Salud Pública (CIBERESP)
  • José Pulido Manzanero Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid; CIBER Epidemiología y Salud Pública (CIBERESP)
  • Luis Sordo del Castillo Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid; CIBER Epidemiología y Salud Pública (CIBERESP)

DOI:

https://doi.org/10.20882/adicciones.1919

Palabras clave:

Opiáceos, heroína, retraso en tratamiento, nuevos usuarios, adicción. Opioids, heroin, treatment delay, new drug users, addiction.

Resumen

La búsqueda temprana de tratamiento para la adicción a los opiáceos se relaciona con un aumento de las posibilidades de éxito en el mismo. Los nuevos pacientes que buscan este tratamiento, y el tiempo que tardan en demandarlo, han sido escasamente descritos en España y Europa. El objetivo del presente estudio es identificar los factores individuales relacionados con el retraso en acudir por primera vez a tratamiento para la adicción a opiáceos. Se realizó un estudio transversal de consumidores de opiáceos admitidos por primera vez a tratamiento por adicción en centros públicos de la Comunidad de Madrid entre los años 2017-2019 (n = 366). Se estableció como variable dependiente el tiempo desde el inicio del consumo hasta el tratamiento (THT). Se realizó un análisis descriptivo general de los usuarios, seguido de un análisis bivariante tras dividir la muestra en dos grupos (THT < 5 años y THT ≥ 5 años). Para identificar aquellos factores asociados a un aumento en el THT se realizó un análisis de regresión logística multivariante. El perfil principal de la población de estudio fue: varón de mediana edad, español y desempleado que consume heroína por vía fumada. La mediana de THT fue: 9,27 años para varones y 4,75 para mujeres. Los factores que se asocian a un mayor THT fueron: > 49 años (OR: 5,87; IC95% 1,73-20,00), desempleo (OR: 2,54; IC95% 1,11-5,83), bajo nivel educativo (OR: 2,18; IC95% 1,04-4,59), no tener hogar (OR: 4,18; IC95% 1,29-13,57), primer consumo fuera del domicilio (OR: 2,54; IC95% 1,11-5,84) y VHC positivo (OR: 2,97; IC95% 1,00-8,82). El retraso en acudir a tratamiento se relaciona con los usuarios de más edad y menor nivel sociocultural. Las personas en riesgo de exclusión social deben priorizarse en las intervenciones para facilitar su acceso a los servicios de tratamiento. 
Early treatment seeking for opioid addiction is related to an increased chance of treatment success. New patients seeking treatment, and the time they take to seek it, have scarcely been described in Spain and Europe. The aim of the present study was to identify individual factors related to the delay in seeking treatment for opiate addiction for the first time. A cross-sectional study of opiate users admitted for the first time to treatment for addiction in public centers in the Community of Madrid between 2017-2019 (n = 366) was conducted. The time from the onset of consumption to treatment (TTT) was the dependent variable. A general descriptive analysis of users was performed, followed by a bivariate analysis after dividing the sample into two groups (TTT < 5 years and TTT ≥ 5 years). To identify those factors associated with an increase in TTT, a multivariate logistic regression analysis was performed. The main profile of the study population was: middle-aged, Spanish, unemployed, male, smoked heroin user. The median TTT was: 9.27 years for men and 4.75 for women. Factors associated with higher TTT were: > 49 years (OR: 5.87; 95%CI 1.73-20.00), unemployment (OR: 2.54; 95%CI 1.11-5.83), low educational level (OR: 2.18; 95%CI 1.04-4.59), homelessness (OR: 4.18; 95%CI 1.29-13.57), first use not at home (OR: 2.54; 95%CI 1.11-5.84) and HCV positive (OR: 2.97; 95%CI 1.00-8.82). Delays in seeking treatment are related to older users and lower sociocultural level. People at risk of social exclusion should be prioritized in interventions to facilitate their access to treatment services.

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Publicado

2025-03-25

Número

Vol. 37 Núm. 1 (2025)

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