Prescription opioid use, misuse, and diversion among street drug users in New York City

Davis, William R.; Johnson, Bruce D.

doi:10.1016/j.drugalcdep.2007.08.008

Cited by 142 publications

(113 citation statements)

References 12 publications

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“…It confirms a recent study in NYC that also indicated that, among street-recruited addicts, only 2.8% indicated having received methadone through a physician or pharmacy. (28) Not surprisingly, more methadone than buprenorphine was reportedly used outside of medical supervision. Buprenorphine has only been available in the U.S. since 2003 and early reports indicate that diversion of buprenorphine has not been widespread nor created significant public health problems when compared with other opioids.…”

Section: Discussionmentioning

confidence: 99%

“…(9,26) Understanding methadone and buprenorphine diversion and its association with public health problems, as well as its connection with the drug abuse treatment process, is of considerable importance given the recent expansion of buprenorphine treatment in the U.S. and the sharp rise in methadone-related overdose deaths in the past few years. (27,28) Although there has been some recent epidemiological research concerning methadone diversion, (29) there has been limited ethnographic research since the work of Hunt and colleagues (30) more than two decades ago. Additionally, little is currently known regarding the uses of diverted buprenorphine or how it compares to the uses of diverted methadone.…”

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confidence: 99%

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Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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This study examined the uses of diverted methadone and buprenorphine among opiate-addicted individuals recruited from new admissions to methadone programs and from out-of-treatment individuals recruited from the streets. Self-report data regarding diversion were obtained from surveys and semi-structured qualitative interviews. Approximately 16% (n=84) of the total sample (N=515) reported using diverted (street) methadone 2-3 times per week for six months or more, and for an average of 7.8 days (SD=10.3) within the past month. The group reporting lifetime use of diverted methadone as compared to the group that did not report such use was less likely to use heroin and cocaine in the 30 days prior to admission (ps < .01) and had lower ASI Drug Composite scores (p < .05). Participants in our qualitative sub-sample (n=22) indicated that street methadone was more widely used than street buprenorphine and that both drugs were largely used as self-medication for detoxification and withdrawal symptoms. Participants reported using low dosages and no injection of either medication was reported.

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Section: Discussionmentioning

confidence: 99%

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Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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“…Available data suggest that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse of prescription opioid analgesics, followed by inhalation and injection. [6,11,[22][23][24][25][26][27][28][29][30][31] Comprehensive data on methods of manipulation and routes of abuse of prescription opioid analgesics have been generated through the US National Health and Wellness Survey. [31] The prevalence of prescription opioid analgesic abuse in the 3 months before the survey was estimated at 1.3% of the adult population in the USA.…”

Section: Frequency Of Different Routes Of Abusementioning

confidence: 99%

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

Gąsior

Bond

Malamut

2015

Postgraduate Medicine

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Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

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“…Reports of PO injection have risen worldwide, including in the United States (Davis and Johnson, 2008;Young et al, 2010;Surrat et al, 2011;Lankenau et al, 2012;Black et al, 2013;MateuGelabert et al, 2015), Europe (Partanen et al, 2009;Keijzer and Imbert., 2011;Roux et al, 2011), South Asia (Larance et al, 2011) and Australia (Degenhardt et al, 2006). In Canada, over the past decade, PO injection has gained in popularity among drug users across the country (UHRI, 2013; Leclerc et al, 2013;Firestone and Fischer, 2008;Roy et al, 2011;Roy et al, 2013;Bruneau et al, 2012;Fischer et al, 2006;PHAC, 2014).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of prescription opioid residue injection

Roy

Arruda

Bertrand

et al. 2016

Drug and Alcohol Dependence

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Background: There is growing evidence of intravenous administration of prescription opioids (POs) in several countries. Preparation of POs for injection may leave residues in containers and filters used by people who inject drugs and may lead to adverse health outcomes if they are injected.Methods: This exploratory study used cross-sectional data from the COSMO study, a prospective cohort of out-of-treatment cocaine users carried out in Montréal (Canada) between October 2010 and August 2015. For this analysis, only one visit per participant was selected, that is, the first time the participant reported PO injection during the study.The outcome of interest, "injection of PO residues", was defined as having injected PO residues from a filter and/or a container in the last month. Correlates of this outcome were identified using logistic regression analyses.Results: Of the 122 participants who reported PO injection during the study period, 41.8% had injected PO residues. Reporting an unstable source of income (AOR=4.26; 95% CI: 1.03-17.69), a recent overdose (AOR=5.45; 95% CI: 1.50-19.88) and a preponderant use of opiates (mostly opiate use versus other drugs excluding alcohol and cannabis) (AOR=2.46; 95% CI: 1.08-5.63) increased the risk of PO residue injection. The odds of reporting PO residue injection rose by 7% per unit increase in the score of psychological distress (AOR=1.07 per unit increase; 95% CI: 1.01-1.12). Conclusions:The findings of this study suggest that PO residue injection is associated with markers of vulnerability. Further investigation is needed in order to better understand this understudied drug injection practice.

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Prescription opioid use, misuse, and diversion among street drug users in New York City

Abstract: POs are an important component of street drug users' drug-taking regimes, especially those who are Physically Ill Chemical Abusers (PICA). Future research is needed to model PO use, misuse, and diversion among this population.

Cited by 142 publications

References 12 publications

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

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

Prevalence and correlates of prescription opioid residue injection

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