@article{ref1,
title="Non-medical prescription opioid use predicts injection initiation among street-involved youth",
journal="International journal on drug policy",
year="2016",
author="Debeck, Kora and Wood, Evan and Dong, Huiru and Dobrer, Sabina and Hayashi, Kanna and Montaner, Julio and Kerr, Thomas",
volume="34",
number="",
pages="96-100",
abstract="Background The impact of prescription opiate (PO) misuse on the incidence of initiation into injection drug use among youth has not been well characterized. This study longitudinally examined non-injection PO misuse and time to injection initiation among street-involved youth.   Methods Data were derived from a prospective cohort of street-involved youth from September 2005 to May 2014. An extended Cox model with time-dependent variables was used to examine the relationship between a history of non-injection PO misuse at baseline and time to injection initiation.   Results At baseline, among 462 injection naïve youth who completed at least one study follow-up to assess for injection initiation, 178 (39%) participants reported having ever misused a PO via non-injection. During study follow-up, 97 (21%) injection initiation events were observed. In multivariable Cox regression analysis, a baseline history of PO misuse was independently associated with time to injection initiation (adjusted relative hazards [ARH] = 1.70, 95% CI: 1.12-2.58) after adjustment for time-updated potential confounders. In sub analysis, dilaudid was the category of PO that was most highly associated with injection initiation (AHR = 1.94, 95% CI: 1.03-3.63).   Conclusion Among a sample of high-risk youth, PO misuse independently predicted injection initiation. These findings underscore the urgent need for interventions to prevent and treat PO use among youth, as a means of preventing initiation of injecting.<p /> <p>Language: en</p>",
language="en",
issn="0955-3959",
doi="10.1016/j.drugpo.2016.05.009",
url="http://dx.doi.org/10.1016/j.drugpo.2016.05.009"
}