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Increasing availability of illicit and prescription opioids among people who inject drugs in a Canadian setting, 2010-2014.

Increasing availability of illicit and prescription opioids among people who inject drugs in a Canadian setting, 2010-2014.
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Ho J, DeBeck K, Milloy MJ, Dong H, Wood E, Kerr T, Hayashi K,


Ho J, DeBeck K, Milloy MJ, Dong H, Wood E, Kerr T, Hayashi K, (click to view)

Ho J, DeBeck K, Milloy MJ, Dong H, Wood E, Kerr T, Hayashi K,

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The American journal of drug and alcohol abuse 2017 10 19() 1-10 doi 10.1080/00952990.2017.1376678

Abstract
BACKGROUND
Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade.

OBJECTIVE
We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada.

METHODS
Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone). We defined perceived availability as immediate (e.g., available within 10 minutes) versus no availability/available after 10 minutes. The trend and correlation of immediate availability were identified by multivariable generalized estimating equations logistic regression.

RESULTS
Among 1584 participants, of which 564 (35.6%) were female, the immediate availability of all illicit and prescribed opioids (except for oxycontin/OxyNEO) increased over time, independent of potential confounders. The Adjusted Odds Ratios of immediate availability associated with every calendar year increase were between 1.09 (95% confidence interval 1.05-1.12) (morphine and Dilaudid) and 1.13 (95% confidence interval 1.09-1.17) (Percocet/Vicodin/Demerol) (all p-values <0.05). CONCLUSION
The availability of most prescription opioids had continued to increase in recent years among our sample of PWID in Vancouver. Concurrent increases in the availability of heroin were also observed, raising concerns regarding combination of both illicit and prescription opioid use among PWID that could potentially increase the risk of overdose.

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