Trends in opioid initiation among people who use opioids in three US cities.
drug use
opioid initiation
women
Journal
Drug and alcohol review
ISSN: 1465-3362
Titre abrégé: Drug Alcohol Rev
Pays: Australia
ID NLM: 9015440
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
01
10
2019
revised:
12
02
2020
accepted:
24
02
2020
pubmed:
7
4
2020
medline:
30
7
2021
entrez:
7
4
2020
Statut:
ppublish
Résumé
The increased availability of prescription opioids (PO) and non-medical prescription opioids (NMPO) has fundamentally altered drug markets and typical trajectories from initiation to high-risk use among people who use opioids (PWUO). This multi-site study explores trends in opioid initiation in three US cities and associations with sociodemographic factors, current drug use and overdose risk. We analysed survey data from a cross-sectional study of PWUO in Baltimore, Maryland (n = 173), Boston, Massachusetts (n = 80) and Providence, Rhode Island (n = 75). Age of first exposure to PO, NMPO and heroin was used to calculate opioid of initiation, and multinomial regression was employed to explore correlates of initiating with each. Thirty-three percent of PWUO initiated with heroin, 24% with PO, 18% with NMPO and 24% with multiple opioids in their first year of use. We observed a reduction in heroin initiation and gradual replacement with PO/NMPO over time. Women were more likely to initiate with NMPO [relative risk ratio (RRR) 2.4; 95% confidence interval (CI) 1.1, 5.0], PO (RRR 2.2, 95% CI 1.1, 4.4) or multiple opioids (RRR 2.1, 95% CI 1.1, 4.2), than heroin. PWUO initiating with NMPO had significantly higher current benzodiazepine use, relative to those initiating with heroin (RRR 3.2, 95% CI 1.4, 7.4), and a high prevalence of current fentanyl use (30%). Our study highlights women and PWUO initiating with NMPO as key risk groups amid the changing landscape of opioid use and overdose, and discusses implications for targeted prevention and treatment.
Substances chimiques
Analgesics, Opioid
0
Heroin
70D95007SX
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
375-383Subventions
Organisme : Center for Aids Research, Johns Hopkins University
ID : 1P30AI094189
Pays : International
Organisme : NIGMS NIH HHS
ID : P20 GM125507
Pays : United States
Organisme : NIDA NIH HHS
ID : T32 DA007292
Pays : United States
Organisme : Center for AIDS Research
Pays : International
Organisme : Johns Hopkins University
Pays : International
Organisme : Johns Hopkins
Pays : International
Informations de copyright
© 2020 Australasian Professional Society on Alcohol and other Drugs.
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