Background And Objectives: While methadone is well established as an evidence-based
treatment for opioid use disorder, safety concerns persist regarding its
diversion. The authors examine the prevalence of and risk factors associated
with injection of methadone in an urban population.
Methods: Between December 2005 and November 2013, data were derived
from two open prospective studies of persons who inject drugs (PWID) in
Vancouver, Canada. Generalized estimating equations (GEE) logistic regression
was used to determine factors independently associated with illicit methadone
injecting.
Results: During the study, 1911 individuals (34% women) were
recruited; 134 (7%) participants reported methadone injecting at least once. In
multivariable analysis, Caucasian ethnicity; homelessness; drug dealing ; ≥daily heroin
injection; ≥daily crack smoking; being a victim of violence;
and non-fatal overdose were
independently and positively associated with methadone injection; female gender was negatively associated.
Discussion and Conclusions: The diversion of methadone for illicit injection in this
urban setting was associated with several markers of addiction severity and
other health and social vulnerabilities.
Scientific Significance: These findings underscore the need to ensure methadone
accessibility while limiting diversion-related risk.
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