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. 2017 Jul 1:176:89-95.
doi: 10.1016/j.drugalcdep.2017.03.011. Epub 2017 May 16.

Increases in prescription opioid injection abuse among treatment admissions in the United States, 2004-2013

Christopher M Jones  1 , Aleta Christensen  2 , R Matthew Gladden  2
Affiliations

Increases in prescription opioid injection abuse among treatment admissions in the United States, 2004-2013

Christopher M Jones et al. Drug Alcohol Depend. .

Abstract

Background: The 2015 HIV outbreak in Indiana associated with prescription opioid injection coupled with rising rates of hepatitis C, especially in areas with long-standing opioid abuse, have raised concerns about prescription opioid injection. However, research on this topic is limited. We assessed trends in treatment admissions reporting injection, smoking, and inhalation abuse of prescription opioids and examined characteristics associated with non-oral routes of prescription opioid abuse in the U.S.

Methods: Prescription opioid abuse treatment admissions in the 2004-2013 Treatment Episode Data Set were used to calculate counts and percentages of prescription opioid treatment admissions reporting oral, injection, or smoking/inhalation abuse overall, by sex, age, and race/ethnicity. Multivariable multinomial logistic regression was used to identify demographic and substance use characteristics associated with injection or smoking/inhalation abuse.

Results: From 2004-2013, oral abuse decreased from 73.1% to 58.9%; injection abuse increased from 11.7% to 18.1%; and smoking/inhalation abuse increased from 15.3% of admissions to 23.0%. Among treatment admissions, the following were associated with injection abuse: male sex, 18-54 year-olds, non-Hispanic whites, non-Hispanic other, homeless or dependent living, less than full-time work, living in the Midwest or South, ≥1 prior treatment episodes, younger age of first opioid use, and reporting use of cocaine/crack, marijuana, heroin, or methamphetamine.

Conclusions: The proportion of treatment admissions reporting prescription opioid injection and smoking/inhalation abuse increased significantly in the U.S. between 2004 and 2013. Expanding prevention efforts as well as access to medication-assisted treatment and risk reduction services for people who inject drugs is urgently needed.

Keywords: Abuse; Injection; Overdose; Prescription opioid.

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Conflict of interest statement

Conflict of interest

The authors report no conflicts.

Figures

Fig. 1.
Fig. 1.
Routes of Abuse among Primary Prescription Opioid Abuse Treatment Admissions by Year, United States, 2004–2013.
Fig. 2.
Fig. 2.
Injection as the Usual Route of Abuse among Primary Prescription Opioid Abuse Treatment Admissions by Census Region, United States, 2004–2013.
See this image and copyright information in PMC

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