Prevalence of opioid analgesic injection among rural nonmedical opioid analgesic users.

Center on Drug and Alcohol Research, University of Kentucky College of Medicine, 915B South Limestone Street, Lexington, KY 40536-9824, USA.
Drug and Alcohol Dependence (Impact Factor: 3.28). 03/2007; 87(1):98-102. DOI: 10.1016/j.drugalcdep.2006.07.008
Source: PubMed

ABSTRACT The purpose of this study was to examine the prevalence and correlates of opioid analgesic injection (OAI) in a cohort of rural opioid analgesic users.
Cross-sectional study of 184 participants from rural Appalachian Kentucky.
The majority of participants were male (54.9%), white (98.4%) and the median age was 30 years (interquartile range: 24-37). The self-reported lifetime prevalence of injection drug use (IDU) was 44.3%, with 35.3% of respondents reporting injection of oral opioid analgesic formulations. The prevalence of self-reported hepatitis C (HCV) was 14.8%, significantly greater than those not injecting opioid analgesics (1.7%) (p<0.001). Receptive needle sharing, distributive needle sharing and sharing of other injection paraphernalia was reported by 10.5%, 26.3%, and 42.1% of those currently injecting, respectively.
Opioid analgesic injection was more prevalent in this rural population than has been found in previous reports. This study suggests a rising problem with injecting among rural opioid users, a problem more typically associated with urban drug users. Educating injectors of opioid analgesics on safe needle practices is necessary in order to curb the transmission of HIV, HCV, and other infectious diseases. Further study on the longitudinal course of opioid analgesic injection in this population appears warranted.

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    • "Similarly, the above studies took place in predominantly urban areas (i.e., New York City; Baltimore, Maryland; Oslo, Norway). It is important to examine the efficacy of interim treatment in the rural and suburban areas where access to maintenance can be especially limited (Fortney and Booth, 2001; Havens et al., 2007; Lenardson and Gale, 2007; Rosenblum et al., 2011; Rounsaville and Kosten, 2000; Sigmon, 2014). Finally, we must learn more about the baseline characteristics that may predict a patient's response to interim opioid treatment. "
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    Preventive Medicine 04/2015; DOI:10.1016/j.ypmed.2015.04.017 · 2.93 Impact Factor
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    • "Since 1999, intentional overdose deaths related to PO have quadrupled and now account for more overdose deaths than heroin and cocaine combined [5]. Young non-medical users of POs are often unaware of the risks associated with their use [6], tending to view prescribed drugs as safer, less stigmatised and less subject to legal penalties than illicit street drugs [7] [8]. Although most non-medical PO use begins with oral ingestion, recent research indicates that a significant minority may transition to the use of heroin and/or administration of opioids by injection, typically within 2–3 years of initiating use [9]. "
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    • "Unfortunately, previous research demonstrates that cocaine injection may not be influenced by increasing access to opioid substitution therapy (Condelli, Fairbank, Dennis, & Rachal, 1991; Grella, Anglin, & Wugalter, 1997) or syringe exchange. In this cohort, however, in contrast to prescription opioid injection, the prevalence of cocaine injection did not rise significantly over the study period of 2001 to 2004 (Havens et al., 2007b). Therefore the influence of cocaine injection on HIV risk among rural Appalachian drug users appears to be constant. "
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