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Factors associated with illicit methadone injecting in a Canadian setting
Author(s) -
Tucker Devin,
Milloy MJ,
Hayashi Kanna,
Nguyen Paul,
Kerr Thomas,
Wood Evan
Publication year - 2015
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/ajad.12257
Subject(s) - methadone , medicine , gee , confidence interval , heroin , odds ratio , generalized estimating equation , methadone maintenance , logistic regression , population , demography , psychiatry , environmental health , drug , statistics , mathematics , sociology
Background and Objectives While methadone is well established as an evidence‐based treatment for opioid use disorder, safety concerns persist regarding its diversion. The authors examine the prevalence of and risk factors associated with injection of methadone in an urban population. Methods Between December 2005 and November 2013, data were derived from two open prospective studies of persons who inject drugs (PWID) in Vancouver, Canada. Generalized estimating equations (GEE) logistic regression was used to determine factors independently associated with illicit methadone injecting. Results During the study, 1911 individuals (34% women) were recruited; 134 (7%) participants reported methadone injecting at least once. In multivariable analysis, Caucasian ethnicity [adjusted odds ratio (AOR) = 1.90, 95% confidence interval (CI) = 1.20–3.00]; homelessness (AOR = 1.46, 95% CI = 1.09–1.95); drug dealing (AOR = 2.10, 95% CI = 1.50–2.93); ≥daily heroin injection (AOR = 1.57, 95% CI = 1.08–2.26); ≥daily crack smoking (AOR = 2.06, 95% CI = 1.44–2.95); being a victim of violence (AOR = 1.48, 95% CI = 1.04–2.12); and non‐fatal overdose (AOR = 1.67, 95% CI = 1.67 (1.00–2.79) were independently and positively associated with methadone injection; female gender (AOR = 0.47, 95% CI = 0.30–0.75) was negatively associated. Discussion and Conclusions The diversion of methadone for illicit injection in this urban setting was associated with several markers of addiction severity and other health and social vulnerabilities. Scientific Significance These findings underscore the need to ensure methadone accessibility while limiting diversion‐related risk. (Am J Addict 2015;24:532–537)