Prime

Type your tag names separated by a space and hit enter

The effect of prescription opioid injection on the risk of non-fatal overdose among people who inject drugs.

Abstract

OBJECTIVES

Prescription opioid (PO) use by people who inject drugs (PWID) is a growing public health concern. Non-fatal overdose remains a leading source of morbidity among PWID, however, little is known about the relationship between PO injection and non-fatal overdose in this population. In this study we sought to examine the impact of PO injection on non-fatal overdose among PWID from Vancouver, Canada.

METHODS

Data were derived from two open prospective cohorts of PWID for the period of December, 2005 to May, 2014. Multivariable generalized estimating equations were used to examine the odds of overdose among those who injected: POs; heroin; and POs and heroin.

RESULTS

In total, 1660 PWID (33.7% women) participated in this study. In multivariable analyses, in comparison to those who were injecting non-opioid drugs, exclusive PO injection was not significantly associated with non-fatal overdose (adjusted odds ratio [AOR]: 1.17, 95% confidence interval [CI]: 0.74-1.86). The odds of non-fatal overdose were elevated for heroin injection (AOR: 1.72, 95% CI: 1.31-2.27), but were greatest for those who injected both heroin and POs (AOR: 2.46, 95% CI: 1.83-3.30).

DISCUSSION

Compared to injecting non-opioids, injecting POs exclusively did not increase risk of non-fatal overdose; however, injecting both POs and heroin doubled the risk. This may reflect consistencies in drug potency and composition when POs are used, as well as unique characteristics of exclusive PO injectors. Our findings call for the continued scale-up of evidence-based overdose prevention interventions for people who inject opioids, including POs.

Links

  • PMC Free PDF
  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada.

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

    ,

    School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada.

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

    ,

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

    British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Electronic address: uhri-tk@cfenet.ubc.ca.

    Source

    Drug and alcohol dependence 156: 2015 Nov 1 pg 297-303

    MeSH

    Adult
    British Columbia
    Cohort Studies
    Comorbidity
    Cross-Sectional Studies
    Drug Overdose
    Female
    Health Surveys
    Heroin Dependence
    Humans
    Male
    Middle Aged
    Prescription Drug Misuse
    Prospective Studies
    Substance Abuse, Intravenous

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26454837

    Citation

    TY - JOUR T1 - The effect of prescription opioid injection on the risk of non-fatal overdose among people who inject drugs. AU - Lake,Stephanie, AU - Hayashi,Kanna, AU - Buxton,Jane, AU - Milloy,M-J, AU - Dong,Huiru, AU - Wood,Evan, AU - Montaner,Julio, AU - Kerr,Thomas, Y1 - 2015/09/30/ PY - 2015/7/14/received PY - 2015/9/23/revised PY - 2015/9/24/accepted PY - 2015/9/30/aheadofprint PY - 2015/10/12/entrez PY - 2015/10/12/pubmed PY - 2016/6/21/medline PY - 2016/11/1/pmc-release KW - Illicit drug use KW - Injection drug use KW - Non-fatal overdose KW - Opioid overdose KW - Prescription opioids SP - 297 EP - 303 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 156 N2 - OBJECTIVES: Prescription opioid (PO) use by people who inject drugs (PWID) is a growing public health concern. Non-fatal overdose remains a leading source of morbidity among PWID, however, little is known about the relationship between PO injection and non-fatal overdose in this population. In this study we sought to examine the impact of PO injection on non-fatal overdose among PWID from Vancouver, Canada. METHODS: Data were derived from two open prospective cohorts of PWID for the period of December, 2005 to May, 2014. Multivariable generalized estimating equations were used to examine the odds of overdose among those who injected: POs; heroin; and POs and heroin. RESULTS: In total, 1660 PWID (33.7% women) participated in this study. In multivariable analyses, in comparison to those who were injecting non-opioid drugs, exclusive PO injection was not significantly associated with non-fatal overdose (adjusted odds ratio [AOR]: 1.17, 95% confidence interval [CI]: 0.74-1.86). The odds of non-fatal overdose were elevated for heroin injection (AOR: 1.72, 95% CI: 1.31-2.27), but were greatest for those who injected both heroin and POs (AOR: 2.46, 95% CI: 1.83-3.30). DISCUSSION: Compared to injecting non-opioids, injecting POs exclusively did not increase risk of non-fatal overdose; however, injecting both POs and heroin doubled the risk. This may reflect consistencies in drug potency and composition when POs are used, as well as unique characteristics of exclusive PO injectors. Our findings call for the continued scale-up of evidence-based overdose prevention interventions for people who inject opioids, including POs. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/26454837/The_effect_of_prescription_opioid_injection_on_the_risk_of_non_fatal_overdose_among_people_who_inject_drugs_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S0376-8716(15)01676-2 ER -