Comparing heroin users and prescription opioid users in a Canadian multi‐site population of illicit opioid users

Fischer, Benedikt; Patra, Jayadeep; Cruz, Michelle Firestone; Gittins, Jude; Rehm, Jürgen

doi:10.1080/09595230801956124

Cited by 74 publications

(59 citation statements)

References 46 publications

(36 reference statements)

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“…However, previous cross-sectional research of urban opioid users found no significant association between prescription opioid use and non-fatal overdose (36, 37). This is inconsistent with our results, which add a longitudinal perspective to the issue, and suggest that urban IDU who use prescription opioids are in fact at a higher risk of non-fatal overdose.…”

Section: Discussionmentioning

confidence: 70%

“…Notably, another Canadian study found that people who used prescription opioids were more likely to report using benzodiazepines and cocaine (36), both of which are well-documented risk factors for overdose, especially when used concurrently with opioids (19, 37, 39–44). While neither benzodiazepine use nor daily cocaine use was significantly associated with non-fatal overdose in our study, it is plausible that the people who use prescription opioids in our sample have a more complex polysubstance profile than those who do not.…”

Section: Discussionmentioning

confidence: 99%

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Prescription opioid use and non-fatal overdose in a cohort of injection drug users

Lake

Wood

Buxton

et al. 2015

The American Journal of Drug and Alcohol Abuse

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Background There is growing concern regarding rising rates of prescription drug-related deaths among the general North American population as well as increasing availability of illicitly obtained prescription opioids. Concurrently among people who inject drugs (IDU), illicit prescription opioid use has increased while non-fatal overdose remains a major source of morbidity. Objectives This study aimed to evaluate whether the use of POs was associated with non-fatal overdose among IDU in Vancouver, Canada. Methods Data was obtained from two open prospective cohorts of IDU between December 2005 and May 2013. We used generalized estimating equation (GEE) logistic regression to evaluate the association between prescription opioid use and non-fatal overdose, adjusting for various social, demographic, and behavioral factors. Results There were 1,614 IDU, including 541 (33.5%) women, who were recruited and included in this analysis. At baseline, 526 (32.6%) reported using POs and 118 (7.3%) reported experiencing an overdose in the previous six months. In a multivariable analysis, prescription opioid use remained independently associated with non-fatal overdose (adjusted odds ratio: 1.61, 95% confidence interval: 1.32–1.95), after adjusting for confounders. Conclusion We observed relatively high rates of prescription opioid use among IDU in this setting, and found an independent association between prescription opioid use and non-fatal overdose. Our data is likely representative of riskier substance use associated with those who use prescription opioids within our sample. Interventions to prevent and respond to overdoses should consider the higher risk profiles of IDU who use prescription opioids.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Prescription opioid use and non-fatal overdose in a cohort of injection drug users

Lake

Wood

Buxton

et al. 2015

The American Journal of Drug and Alcohol Abuse

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“…Although rates vary geographically, recent estimates of prescription drug misuse among IDUs were 80–91% (Fischer et al 2008; Havens, Walker & Leukefeld 2007). The risks associated with injection of illicit drugs and transmission of blood-borne infections, such as hepatitis C (HCV) and HIV, due to shared needles, drug solutions, and drug equipment, frequent injection, and young age at injection initiation are well documented (Chaisson et al 1987; Doherty et al 2000; Garfein et al 1996; Green et al 1993; Jose et al 1993; Nelson et al 2002; Schoenbaum et al 1989; Shah et al 1996).…”

Section: Introductionmentioning

confidence: 99%

“…While several studies have looked at prescription drug misuse among illicit drug users (Davis & Johnson 2008; Firestone & Fischer 2008; Fischer et al 2008; Sigmon 2006), examining unsafe injection and sexual practices among those who inject prescription drugs has been understudied. A recent qualitative study conducted in Montreal found that the sharing of “washes,” or opioid residues, was a common practice among IDUs injecting prescription opioids (Roy, Arruda & Bourgois 2011), underscoring the need to identify risk behaviors among injectors of prescription medications.…”

Section: Introductionmentioning

confidence: 99%

Prescription Drug Misuse and Risk Behaviors Among Young Injection Drug Users

Johnson

Fibbi

Langer

et al. 2013

Journal of Psychoactive Drugs

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Prescription drug misuse among young adults, especially opioids, is a substantial public health problem in the United States. Although risks associated with injection of illicit drugs are well established, injection and sexual risks associated with misuse of prescription drugs are under-studied. Forty young injection drug users aged 16 to 25 who reported injection of a prescription drug were recruited in 2008–09 in Los Angeles and New York City. Descriptive quantitative and qualitative data were analyzed to illustrate risky injection and sexual behaviors reported in this sample. Over half of participants engaged in risky injection behavior, three-quarters engaged in risky sexual behavior, nearly half reported both risky behaviors, and five did not report either risk behavior while misusing a prescription drug. Prescription opioids, tranquilizers, and stimulants were misused in the context of risky sexual behaviors while only opioids were misused in the context of injection risk behaviors. Access to clean syringes, attitudes and beliefs regarding hepatitis C, and risk reduction through partner selection were identified as key themes that contextualized risk behaviors. Although these findings help identify areas to target educational campaigns, such as prevention of sexually transmitted infections, risk behaviors specifically associated with prescription drug misuse warrant further study.

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“…This is especially important because recent research has shown that those who abuse prescription opioids possess different characteristics than those who abuse illicit drugs, such as heroin. Specifically, studies have found that those who abuse prescription opioids had lower addiction severity, less intravenous (IV) drug 532 PARENTAL PRESCRIPTION OPIOID ABUSE 533 use, higher household stability, less sedative use, and less criminal involvement compared with those abusing heroin (14)(15)(16). Although these studies did not look exclusively at parental drug abuse, they suggest that those abusing prescription opioids possess a number of different characteristics compared with heroin users.…”

Section: Introductionmentioning

confidence: 90%