Associations between prescription opioid injection and Hepatitis C virus among young injection drug users

Abstract

Objective Hepatitis C virus (HCV) incidence has been increasing among young injection drug users (IDUs). This analysis examined whether the emerging practice of prescription opioid (PO) injection is associated with self-reported HCV among young IDUs. Methods Young IDUs (n = 162) aged 18–25-years-old who indicated recent misuse of prescription drugs were sampled in New York and Los Angeles during 2009–2011. Participants reported lifetime PO injection history and results from their most recent HCV test as well as demographic characteristics and lifetime drug use. Bivariate analyses examined relationships between covariates and both lifetime PO injection and HCV positivity. Poisson regression examined the associations between lifetime PO injection, HCV positivity, and significant covariates. Results A majority reported lifetime PO injection (72.2%) and 30.9% self-reported being HCV positive. Lifetime PO injectors were nearly three times more likely to report being HCV positive than non-PO injectors (adjusted incidence rate ratio (AIRR): 2.69, p<0.05) after controlling for socio-demographic and other drug use variable. Additionally, substituting POs for heroin (AIRR: 2.27, p<0.05), growing up in a lower social class (AIRR: 1.67, p<0.05), age (AIRR: 1.12, p<0.05), age of injection initiation (AIRR: 0.87, p<0.001), and history of being prescribed stimulants (AIRR: 0.64, p<0.05) were independently associated with HCV positivity. Conclusions Findings suggest that PO injection should be given further consideration as a contributing factor to rising HCV infection among young adults in the US.

Social context and perspectives of non‐medical prescription opioid use among young adults in Rhode Island: A qualitative study

“…13,18–24 However, these studies have been conducted outside of the New England region, primarily New York City, San Francisco, Los Angeles, Philadelphia, Ohio, and Florida. To our knowledge no studies have examined the context and perspective of NMPO use among young adults in New England, a region where Rhode Island and nearby states are struggling with an opioid and overdose crisis.…”

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

“…[73] Individuals who abuse prescription opioid analgesics via injection have been shown to be at greater risk of serious infectious diseases, including hepatitis C virus and HIV infection. [30,[74][75][76][77][78] In the recent HIV outbreak in Indiana in a population historically at low risk of infection, the majority of cases were found to be linked to intravenous abuse of oxymorphone. [78] Serious cutaneous complications have also been reported in individuals who crush and inject buprenorphine tablets; such complications appear to be at least in part due to the presence of silica in generic formulations.…”

Management of opioid use disorders: a national clinical practice guideline

“…[5][6][7] For 2016, the mean rate of apparent opioid-related overdose deaths has reached 7.9 per 100 000 population (i.e., corresponding to a total of 2861 fatalities), with the highest death rates reported for western Canada. 8 This upsurge in opioid-related harms, including overdose deaths, [2][3][4][5][6]8,9 underscores the critical need for coordinated, evidence-based approaches to prevention, treatment and harm reduction to address this national public health emergency.…”