Abstract
BackgroundNonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. At a population-level, previous research has identified differences in the prevalence and correlates of NMPOU among younger versus older age groups; however, less is known about age-related differences in NMPOU among people who use illegal drugs.MethodsData were collected between 2013 and 2015 from two linked prospective cohort studies in Vancouver, Canada: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Factors independently associated with NMPOU among younger (ARYS) and older (VIDUS) participants were examined separately using bivariate and multivariate generalized estimating equations.ResultsA total of 1162 participants were included. Among 405 eligible younger participants (Median age = 25; Inter-Quartile Range [IQR]: 22–28), 40% (n = 160) reported engaging in NMPOU at baseline; among 757 older participants (Median age = 48, IQR: 40–55), 35% (n = 262) reported engaging in NMPOU at baseline. In separate multivariate analyses of younger and older participants, NMPOU was positively and independently associated with heroin use (younger: Adjusted Odds Ratio [AOR] = 3.12, 95% Confidence Interval [CI]: 2.08–4.68; older: AOR = 2.79, 95% CI: 2.08–3.74), drug dealing (younger: AOR = 2.22, 95% CI: 1.58–3.13; older: AOR = 1.87, 95% CI: 1.40–2.49), and difficulty accessing services (younger: AOR = 1.47, 95% CI: 1.04–2.09; older: AOR = 1.74, 95% CI: 1.32–2.29). Among the youth cohort only, NMPOU was associated with younger age (AOR = 1.12, 95% CI: 1.05–1.19), crack use (AOR = 1.56, 95% CI: 1.06–2.30), and binge drug use (AOR = 1.41, 95% CI: 1.00–1.97); older participants who engaged in NMPOU were more likely to report crystal methamphetamine use (AOR = 1.97, 95% CI: 1.46–2.66), non-fatal overdose (AOR = 1.76, 95% CI: 1.20–2.60) and sex work (AOR = 1.49, 95% CI: 1.00–2.22).DiscussionThe prevalence of NMPOU is similar among younger and older people who use drugs, and independently associated with markers of vulnerability among both age groups. Adults who engage in NMPOU are at risk for non-fatal overdose, which highlights the need for youth and adult-specific strategies to address NMPOU that include better access to health and social services, as well as a range of addiction treatment options for opioid use. Findings also underscore the importance of improving pain treatment strategies tailored for PWUD.
Highlights
Nonmedical prescription opioid use (NMPOU) is a serious public health problem in North America
Research consistently indicates that adolescents and young adults are more likely to engage in nonmedical prescription opioid use (NMPOU) than older youth and adults [3,4,5,6,7,8,9,10,11], and evidence suggests that these differences in prescription opioid (PO) use are associated with statistically significant birth cohort effects; more recent birth cohorts have higher lifetime and past-year prevalence of prescription opioid -use disorder due to NMPOU [12]
The results indicate high rates of illegal polysubstance use in the At-Risk Youth Study (ARYS) and Vancouver Injection Drug Users Study (VIDUS) cohorts, participants who only engage in NMPOU may experience additional difficulties accessing harm reduction services that are tailored to people who use illegal drugs, since they and their social networks may be outside the scope of outreach activities conducted by these services [75, 76]
Summary
Nonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. Adolescents and young adults in the United States are more likely to initiate NMPOU than older age groups [3, 13,14,15], and a study of the American general population found that the most frequently reported age of NMPOU initiation was 16–18 years [16] This effect has been attributed to the increased availability of POs [4], and other research among street-involved youth has found that the easy availability of POs facilitates NMPOU [17]. “Adult” and “older age groups” include those over the age of majority but focuses on those in their mid-life and older
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
