Prescription drug use and misuse in a cohort of people who inject drugs (PWID) in Baltimore

Abstract

Prescription drug use was highly prevalent among PWID. While it is difficult to distinguish medically indicated from non-medical use, high levels of prescription drug use in conjunction with other drugs and alcohol heightens the risk for drug overdose and other adverse consequences.

Association of Injection Practices and Overdose With Drug Use Typologies: A Latent Class Analysis Among People Who Inject Drugs in Baltimore, 2017

“…The prevalence of using illicitly obtained prescription opioids in our study using data from 2017 was similar to previous estimates among ALIVE participants in 2005–2014 (8–17% used prescription opioids) (Khosla et al, 2011; Anagnostopoulos et al, 2018; Genberg et al, 2013). However, use of illicitly obtained prescription sedatives and/or tranquilizers was more common than previous estimates (approximately 5–12%), though this likely reflects the inclusion criteria we applied (i.e.…”

“…However, use of illicitly obtained prescription sedatives and/or tranquilizers was more common than previous estimates (approximately 5–12%), though this likely reflects the inclusion criteria we applied (i.e. use of an illicit substance or illicitly obtained prescription drugs in the past six months) (Anagnostopoulos et al, 2018; Khosla et al, 2011). Polysubstance use among participants who used prescription drugs (e.g., heroin, cocaine, alcohol, and marijuana) remained common, and may contribute to the increased nonfatal overdose risk in this group relative to infrequent use, especially given the dangers of combining opioids with prescription tranquilizers (e.g.…”

“…Analyses of syringe sharing and obtaining syringes were restricted to current PWID (i.e., participants who injected drugs in the past six months). Multivariable analyses adjusted for several potential confounders that were previously associated with drug use patterns and/or injection behaviors, including demographic characteristics (age, African American race, and gender), homelessness, HIV (status and viral load detectability), depressive symptoms, and alcohol use (Anagnostopoulos et al, 2018; Fu et al, 2012; Khosla et al, 2011; Knowlton et al, 2000; Linton, Celentano, Kirk, & Mehta, 2013; Song, Safaeian, Strathdee, Vlahov, & Celentano, 2000).…”

“…Drug use and its consequences have remained pervasive public health challenges in urban areas, including Baltimore, which has documented increased opioid overdose mortality rates alongside use of illicitly obtained prescription opioids and the contamination of the heroin supply with fentanyl (MDHMH, 2018; Park, Weir, Allen, Chaulk, & Sherman, 2018). While prescription drug use appears to be prevalent among current and former PWID in Baltimore, the polysubstance patterns that include heroin, cocaine, and prescription opioids have not been fully characterized in the fentanyl-era, nor has the relationship of these polysubstance use patterns with HIV risk behaviors and overdose been examined (Anagnostopoulos, Abraham, Genberg, Kirk, & Mehta, 2018; Khosla, Juon, Kirk, Astemborski, & Mehta, 2011). Using data from 2017, we characterized the predominant substance use typologies among a sample of 671 current and former PWID who participated in the AIDS Linked to the IntraVenous Experience Study (ALIVE) in Baltimore, MD, using a latent class analysis (LCA) (Vlahov et al, 1991).…”

The epidemiology of benzodiazepine misuse: A systematic review

“…Benzodiazepine misuse was associated with poorer selfreported quality of life Individuals with opioid use, illicit/prescription drug misuse, or injection drug use Benzodiazepine misuse was associated with poorer selfreported quality of life (Becker et al, 2007;Darke et al, 1993;Deacon et al, 2016;Lavie et al, 2009;Lugoboni et al, 2014;Millson et al, 2006) Ongoing benzodiazepine misuse during treatment was associated with poorer physical health (Darke et al, 2010;Eiroa-Orosa et al, 2010) Benzodiazepine misuse was associated with greater pain severity (Anagnostopoulos et al, 2018;Moses et al, 2018) Benzodiazepine misuse was associated with greater sleep dysfunction (Blanco et al, 2013;Manconi et al, 2017;Mazza et al, 2014;Peles et al, 2009) Other subgroups (e.g., healthcare workers, adolescents in the emergency department)…”