Nonmedical prescription opioid use and illegal drug use: initiation trajectory and related risks among people who use illegal drugs in Vancouver, Canada

Tessa Cheng, Will Small, Ekaterina Nosova, Bob Hogg, Kanna Hayashi, Thomas Kerr, Kora DeBeck, Tessa Cheng, Will Small, Ekaterina Nosova, Bob Hogg, Kanna Hayashi, Thomas Kerr, Kora DeBeck

Abstract

Objective: We investigated the prevalence of and risk factors associated with initiating nonmedical prescription opioid use (NMPOU) before and after illegal drugs using data from two linked cohort studies of street youth and adults who use illegal drugs in Vancouver, Canada. All participants who attended a study visit between 2013 and 2016 were eligible for the primary analyses.

Results: Among 512 youth and 833 adult participants, the prevalence of NMPOU was extremely high (88% among street youth; 90% among adults), and over one-third of those who reported engaging in NMPOU had initiated NMPOU before illegal drug use (vs. transitioning from illegal drugs to NMPOU). Participants who reported either transitioning to or from NMPOU had higher risk profiles, particularly related to substance use, when compared with those who reported never engaging in NMPOU. Sub-analyses restricted to only those who engaged in NMPOU found few statistically significant differences between those who initiated NMPOU prior to illegal drugs versus those who initiated illegal drugs prior to NMPOU. Findings suggest that among people who use illegal drugs, early NMPOU trajectories do not appear to critically shape future patterns and practices.

Keywords: Addiction; Prescription opioid; Risk behaviour; Street youth.

References

    1. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71:821–826. doi: 10.1001/jamapsychiatry.2014.366.
    1. Suryaprasad AG, White JZ, Xu FJ, Eichler BA, Hamilton J, Patel A, Hamdounia SB, Church DR, Barton K, Fisher C, et al. Emerging epidemic of hepatitis c virus infections among young nonurban persons who inject drugs in the United States, 2006–2012. Clin Infect Dis. 2014;59:1411–1419. doi: 10.1093/cid/ciu643.
    1. Dertadian GC, Maher L. From oxycodone to heroin: two cases of transitioning opioid use in young Australians. Drug Alcohol Rev. 2014;33:102–104. doi: 10.1111/dar.12093.
    1. Grau LE, Dasgupta N, Harvey AP, Irwin K, Givens A, Kinzly ML, Heimer R. Illicit use of opioids: is OxyContin a “gateway drug”? Am J Addict. 2007;16:166–173. doi: 10.1080/10550490701375293.
    1. Pollini RA, Banta-Green CJ, Cuevas-Mota J, Metzner M, Teshale E, Garfein RS. Problematic use of prescription-type opioids prior to heroin use among young heroin injectors. Subst Abuse Rehabilit. 2011;2:173–180. doi: 10.2147/SAR.S24800.
    1. Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers—United States, 2002–2004 and 2008–2010. Drug Alcohol Depend. 2013;132:95–100. doi: 10.1016/j.drugalcdep.2013.01.007.
    1. Lawson KM, Back SE, Hartwell KJ, Moran-Santa Maria M, Brady KT. A comparison of trauma profiles among individuals with prescription opioid, nicotine, or cocaine dependence. Am J Addict. 2013;22:127–131. doi: 10.1111/j.1521-0391.2013.00319.x.
    1. Fischer B, Patra J, Cruz MF, Gittins J, Rehm J. Comparing heroin users and prescription opioid users in a Canadian multi-site population of illicit opioid users. Drug Alcohol Rev. 2008;27:625–632. doi: 10.1080/09595230801956124.
    1. Subramaniam GA, Stitzer MA. Clinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder. Drug Alcohol Depend. 2009;101:13–19. doi: 10.1016/j.drugalcdep.2008.10.015.
    1. DeMatteo D, Major C, Block B, Coates R, Fearon M, Goldberg E, King SM, Millson M, O’Shaughnessy M, Read SE. Toronto street youth and HIV/AIDS: prevalence, demographics, and risks. J Adolesc Health. 1999;25:358–366. doi: 10.1016/S1054-139X(99)00059-2.
    1. Marshall BD. The contextual determinants of sexually transmissible infections among street-involved youth in North America. Cult Health Sex. 2008;10:787–799. doi: 10.1080/13691050802295719.
    1. Roy E, Haley N, Leclerc P, Sochanski B, Boudreau JF, Boivin JF. Mortality in a cohort of street youth in Montreal. JAMA. 2004;292:569–574. doi: 10.1001/jama.292.5.569.
    1. Wood E, Stoltz JA, Montaner JS, Kerr T. Evaluating methamphetamine use and risks of injection initiation among street youth: the ARYS study. Harm reduction journal. 2006;3:18. doi: 10.1186/1477-7517-3-18.
    1. Hadland SE, Marshall BD, Kerr T, Qi J, Montaner JS, Wood E. Depressive symptoms and patterns of drug use among street youth. J Adolesc Health. 2011;48:585–590. doi: 10.1016/j.jadohealth.2010.09.009.
    1. Office of the Provincial Health Officer . BC opioid substitution treatment system, performance measures 2013/2014. Victoria: British Columbia Ministry of Health; 2015.
    1. R Core Team: R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna; 2016.
    1. Darke S. Self-report among injecting drug users: a review. Drug Alcohol Depend. 1998;51:253–263. doi: 10.1016/S0376-8716(98)00028-3.
    1. Weatherby NL, Needle R, Cesari H, Booth R, Mccoy CB, Watters JK, Williams M, Chitwood DD. Validity of self-reported drug-use among injection-drug users and crack cocaine users recruited through street outreach. Eval Progr Plan. 1994;17:347–355. doi: 10.1016/0149-7189(94)90035-3.

Source: PubMed

3
Suscribir