TY - JOUR PY - 2016// TI - Non-medical prescription opioid use predicts injection initiation among street-involved youth JO - International journal on drug policy A1 - Debeck, Kora A1 - Wood, Evan A1 - Dong, Huiru A1 - Dobrer, Sabina A1 - Hayashi, Kanna A1 - Montaner, Julio A1 - Kerr, Thomas SP - 96 EP - 100 VL - 34 IS - N2 - 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.

Language: en

LA - en SN - 0955-3959 UR - http://dx.doi.org/10.1016/j.drugpo.2016.05.009 ID - ref1 ER -