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.
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.
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. The odds of non-fatal overdose were elevated for heroin
injection, but were greatest for those who
injected both heroin and POs.
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.
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- 1British 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.
- 2British 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.
- 3School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada.
- 4British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
- 5British 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.
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