Illicit Opioid Use in Canada: Comparing Social, Health, and Drug Use Characteristics of Untreated Users in Five Cities (OPICAN Study)

Fischer, Benedikt; Rehm, Jürgen; Brissette, Suzanne; Brochu, Serge; Bruneau, Julie; el‐Guebaly, Nady; Noël, Lina; Tyndall, Mark W.; Wild, C.; Mun, Phil; Baliunas, Dolly

doi:10.1093/jurban/jti049

Cited by 156 publications

(126 citation statements)

References 63 publications

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“…It has been previously reported that there is a higher proportion of injection equipment sharing and overdoses in Montreal compared to Vancouver. 8,51 Broad implementation of harm reduction measures such as a decentralized needle exchange and a supervised injection facility in Vancouver may contribute to lower levels of risky injection practices. On the other hand, Montreal participants have received more psychological treatment than Vancouver and have been on MMT more times.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Institutional sources estimate approximately 80,000 regular opioid users in Canada 6 with geographic differences in prevalence and trends. Although the "street" availability of prescription analgesic opioids such as hydromorphone and morphine has increased in recent years, 7,8 intravenous use of heroin prevails in Vancouver and Montreal. 5,[9][10][11] Injectors are exposed to life-threatening health risks such as drug overdoses, bloodborne viral infections, endocarditis, and others.…”

Section: Introductionmentioning

confidence: 99%

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The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

et al. 2008

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Standardized assessment instruments such as the European Addiction Severity Index and the Maudsley Addiction Profile were employed. A total of 251 individuals were randomized from Vancouver, BC (192, 76.5%), and Montreal, Quebec (59, 23.5%); 38.5% were female, the mean age was 39.7 years (SD:8.6), and participants had injected drugs for 16.5 years (SD:9.9), on average. In the prior month, heroin was used a mean of 26.5 days (SD:7.4) and cocaine 16 days (SD;12.6). Vancouver had significantly more patients residing in unstable housing (88.5 vs. 22%; pG0.001) and higher use of smoked crack cocaine (16.9 days vs. 2.3 days in the prior month; pG0.001), while a significantly higher proportion of Montreal participants reported needle sharing in the prior 6 months (25% vs. 3.7%; pG0.001). In many respects, the patient cohort was similar to the European trials; however, NAOMI had a higher proportion of female participants and participants residing in unstable housing. This study suggests that the NAOMI study successfully recruited participants with a profile indicated for HAT. It also raises concern about the high levels of crack cocaine use and social marginalization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

et al. 2008

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“…[5][6][7] The proportion of drug users who smoke crack cocaine and are homeless or have marginal housing has recently been reported to be as high as 86.6% in Vancouver, 66.7% in Edmonton and 62.4% in Toronto. 8 In the United States, a seminal cross-sectional study involving inner-city young adults showed that smoking of crack cocaine was associated with HIV infection. 9 However, in Canada, despite the documentation of changing patterns of drug use in many communities, 8 little is known about the impact that increased smoking of crack cocaine has had on the HIV epidemic.…”

mentioning

confidence: 99%

Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs

DeBeck¹,

Kerr²,

Li³

et al. 2009

Canadian Medical Association Journal

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“…As also shown elsewhere, cocaine injection in a large number of instances occurs in combination with other drugs (typically opioids, i. e., so-called injected »speed-ball«; Fischer et al, 2005a). The vast majority (87.2 %) of those who also used crack used the drug by inhaled (smoked) route of administration.…”

Section: S P E C I a L I S S U Ementioning

confidence: 73%

Differences between co-users of cocaine and crack among Canadian illicit opioid users

Fischer¹,

Monga²,

Manzoni³

2005

SUCHT

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Unterschiede zwischen Ko-Gebrauchern von Kokain und Crack bei kanadischen Opioid-Konsumenten Fragestellung: Es wurden Unterschiede zwischen Ko-Gebrauchern von Kokain und Crack in einer kanadischen Kohorte illegaler Opioid-Konsumenten (»OPICAN«) untersucht. Methodik: Kohortenteilnehmer wurden durch Schneeball-Methoden rekrutiert und mittels eines standardisierten Instrumenten-Protokolls befragt. Prävalenzraten verschiedener Substanzen sowie Unterschiede zwischen ausgewählten Indikatoren und den beiden Subgruppen wurden bivariat geprüft. Ergebnisse: Zirka die Hälfte der Studienteilnehmer indizierten Ko-Konsum von Crack beziehungsweise Kokain. Erstere Gruppe zeichnete sich primär durch sozioökonomische Marginalisierung, zweitere durch eine höhere Prävalenz von Depression aus. Schlussfolgerungen: Ko-Gebraucher von Opioiden mit Kokain und Crack in Kanada können als distinkte Subkulturen mit spezifischen Risikofaktoren angesehen werden. Ausgewählte Implikationen für Interventionen werden angesprochen.

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Illicit Opioid Use in Canada: Comparing Social, Health, and Drug Use Characteristics of Untreated Users in Five Cities (OPICAN Study)

Abstract: Most of the estimated 125,000 injection drug users (IDUs)

Cited by 156 publications

References 63 publications

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs

Differences between co-users of cocaine and crack among Canadian illicit opioid users

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