Epidemiology of Injection Drug Use

Abstract

After more than 30 years of research, numerous studies have shown that injection drug use is associated with a wide range of adverse health outcomes such as drug overdoses, drug-related suicidal behaviours, comorbid psychiatric disorders, bloodborne pathogens and other infectious diseases, and traumas. This review explores new trends and prominent issues associated with injection drug use. The dynamic nature of injection drug use is underlined by examining its recent trends and changing patterns in Canada and other ''high-income countries.'' Three research topics that could further contribute to the development of comprehensive prevention and intervention strategies aimed at people who inject drugs are also discussed: risk behaviours associated with the injection of prescription opioids, binge injection drug use, and mental health problems as determinants of injection risk behaviours. Abré géAprès plus de 30 ans de recherche, de nombreuses études ont révélé que l'utilisation de drogue par injection est associée à une vaste gamme d'effets indésirables sur la santé, comme les surdoses de drogue, les comportements suicidaires liés aux drogues, les troubles psychiatriques comorbides, les pathogènes et autres maladies infectieuses transmis par le sang, et les traumas. Dans cette revue, les nouvelles tendances et les principaux enjeux associés à l'utilisation de drogue par injection sont explorés. La nature dynamique de l'utilisation de drogue par injection est soulignée en en examinant les récentes tendances et modèles changeants au Canada et dans d'autres « pays à revenu élevé ». Trois sujets de recherche qui pourraient contribuer au développement de stratégies complètes de prévention et d'intervention axées sur les personnes qui utilisent des drogues par injection sont aussi présentés: les comportements à risque associés à l'injection d'opioïdes d'ordonnance, l'utilisation excessive de drogue par injection, et les problèmes de santé mentale en tant que déterminants des comportements d'injection à risque.Keywords injection drug use, drug use patterns, drug trends, injection risk behaviours Drug overdoses, drug-related suicidal behaviours, comorbid psychiatric disorders, HIV and hepatitis C virus (HCV) infections, other infectious diseases, and traumas are among the most serious health consequences of substance misuse.

Prescription opioid injection among young people who inject drugs in New York City: a mixed-methods description and associations with hepatitis C virus infection and overdose

“…Qualitative interview findings reveal that PO injection often necessitates the use of 1.0 cc syringes or the administration of multiple injections with smaller syringes (0.5 cc) due to the additional water that is needed to dissolve extendedrelease and/or abuse-deterrent opioid pills in aqueous solution. These multi-step pill injection practices can increase the likelihood of sharing and cross-contaminating injection equipment, thereby increasing the risk of HIV [29] and HCV transmission [6,28,30]. Our findings corroborate results from other qualitative studies that describe the unique mechanics involved in preparing and injecting POs [8,11].…”

“…The lower prevalence of PO injection in our NYC sample might be explained by regional differences in drug markets. Heroin in NYC is widely available and significantly cheaper than diverted POs, allowing PWID to choose between POs and heroin based on their incomegenerating strategies and SES, whereas in Canada [29], heroin is available but more expensive than POs, and in certain rural areas of the USA, like Kentucky [3], heroin is difficult to access, which can necessitate more frequent PO injection, even in places where POs are exceedingly expensive (e.g., Scott County, Indiana). Our qualitative findings illustrate how the preparation and injection practices associated with the parenteral administration of POs (e.g., multiple drug washes, reuse of drug paraphernalia containing drug residue, multiple injections per injection episode) place PWID at increased risk for blood-borne infection.…”

Global Mortality Burden of Cirrhosis and Liver Cancer Attributable to Injection Drug Use, 1990–2016: An Age-Period-Cohort and Spatial Autocorrelation Analysis

“…Injection drug use (IDU) is not only a serious social problem, but also a public health problem that is an effective transmission route of blood-borne pathogens including HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV) [ 1 , 2 ]. Traditional HBV/HCV transmission routes such as iatrogenic injections, blood transfusion and mother-to-child transmission have been attenuated through effective public health interventions including screening of blood donors and mass vaccination of HBV [ 3 , 4 ].…”

Epidemiology, Microbiology, and Clinical Outcomes Among Patients With Intravenous Drug Use-Associated Infective Endocarditis in New Brunswick

“…An epidemic of nonmedical opioid use is sweeping across Canada, including intravenous drug use (IVDU). 1 An estimated 172,000 Canadians engage in IVDU, 2 , 3 and New Brunswick is thought to have the second-highest rates of IVDU in Canada at around 1% of the population. 3 IVDU carries an increased risk of serious medical complications, including infective endocarditis (IE).…”