Comparing Injecting and Non-Injecting Illicit Opioid Users in a Multisite Canadian Sample (OPICAN Cohort)

Abstract

Illicit opioid use in Canada and elsewhere increasingly involves a variety of opioids and non-injection routes of administration. Injection and non-injection opioid users tend to differ in various key characteristics. From a public health perspective, non-injection routes of opioid use tend to be less harmful due to lesser morbidity and mortality risks. Our study compared current injectors (80%) and non-injectors (20%) in a multi-site sample of regular illicit opioid users from across Canada (‘OPICAN’ study). In bivariate analysis, injectors and non-injectors differed by prevalence in social and health characteristics as well as drug use. Logistic regression analysis identified city, drug use, housing status and mental health problems as independent predictors of injection status. Further analysis revealed that the majority of current non-injectors had an injection history. Our results reinforce the need to explore potential interventions aimed at preventing the transition from non-injectors to injecting, or facilitating the transition of injectors to non-injecting, as initiated in several other contexts.

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

“…Second, a specific examination of those who also used crack, compared with those who did not also use crack, revealed that the former were significantly more likely to be characterized by key indicators of social and health risks or harms, including unstable housing, criminal activity, health problems, and injection risks (110). Finally, a more detailed examination of the current noninjectors in the cohort revealed that most had an injection history and were older, suggesting that they had matured out of drug use by injection (43).…”

“…At the same time, opioid injectors may shift to noninjection forms in search of less risky forms of drug use or as a step in maturing out of their use habits altogether (42). Given the substantially increased levels of risks and harms associated with injection forms of opioid use, both ends of the transition trajectory have enormously important implications for prevention, yet they are little understood or used in interventions (43)(44)(45).…”

Cannabis Use Correlates of Syringe Sharing among Injection Drug Users

“…1,2 In both cases, viral transmission occurs mainly through sharing of contaminated syringes. 3,4 In spite of the availability of an extensive syringe exchange network, with access sites situated in the places where they are most needed, 5 Montreal surveillance data have shown an increase in the incidence of HIV from 3.5 cases per 100 person-years between 1998 and 2002 to 4.9 cases per 100 person-years between 2003 and 2006.…”

Examining the Relationship between Social Context and Prescription Opioid Initiation Routes among Young Adults Entering Medical Detoxification

“…school, parties) has also been found to influence the decision to initiate; setting, coupled with peer use and exposure, helps to normalize prescription drug abuse, creating comfort in the perception that use is common and fun [16]. Social and environmental contexts have also been found to contribute to transitions to alternative routes of administration, including drug injecting among established illicit PO users [5,10,17,18].…”