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 M-J, Dong H, Wood E, Kerr T, Hayashi K. (2017). Increasing availability of illicit and prescription opioids among people who inject drugs in a Canadian setting, 2010-2014.The American Journal of Drug and Alcohol Abuse. 

Date created: 
Prescribed opioids
Illicit opioids
Injected drugs

Background: The increase over the past decade in the non-medical use of prescription opioids and illicit opioids in North America has resulted in significant health-related harms.

Objective: We sought to examine 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) vs. 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 opioids use among PWID that could potentially increase the risk of overdose.


The fulltext of this paper will be available in June 2018 due to the embargo policies of The American Journal of Drug and Alcohol Abuse for works funded by the Canadian Institutes of Health Research (CIHR). Contact to enquire if the full text of the accepted manuscript can be made available to you.

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Rights remain with the authors.
Canadian Institutes of Health Research (CIHR)
Michael Smith Foundation for Health Research (MSFHR)