Non-medical prescription opioid (NMPO) use is a serious public health problem in the United States. Although NMPO-related health and social harms, including opioid dependence, lost productivity, and overdose are major causes of morbidity and mortality, initiation of injection drug use and infectious disease specific consequences, including HIV and hepatitis C virus (HCV) infection, are crucially understudied. The objective of this project is to examine the context and epidemiology of injection drug use as well as HIV- and HCV-related risk behaviors among young adult NMPO users. The ultimate goal of this pilot study is to use these data to inform the development of a prospective cohort study to determine the multi-level risk factors for initiation of injection drug use in this population. Specifically, the proposed stdy has the following aims: (1) to compare and evaluate the feasibility of two novel sampling methods to recruit young adult NMPO users;and (2), to explore social, macro-social, and drug-related factors associated with HIV risk behavior and transitions to injection drug use among young adult NMPO users. To achieve these aims, we will conduct a pilot study of 200 NMPO users aged 18 to 25 who reside in Rhode Island (RI), a state that is among the highest in the prevalence of NMPO use among young adults. To achieve Aim 1, we will compare the efficiency, cost, and sample composition of two novel recruitment strategies, including a combination of targeted canvassing and respondent-driven sampling, as well as mixed internet-based recruitment from drug information and social media websites. To achieve Aim 2, we will assess non-injectors'perceptions of risk for initiating injection. We will also examine the relationship between social, macro-social, and drug-related risk factors (e.g., diversion from family members, social network characteristics, denial of opioids for pain control, progression to heroin use following abuse-deterrent reformulations) and HIV risk behaviors and transitions to injection drug use. Finally, to assess receipt of opioid prescriptions from multiple physicians as risk factor for injecting initiation, we will obtain past-year opioid dispensation histories by conducting a deterministic, confidential data linkage to the RI prescription monitoring program. This study has important implications for improved prescription opioid exposure assessments as well as the development of novel sampling methodologies to access members of a population that, due to the hidden and amorphous nature of NMPO use, has been challenging to study. This research will address several questions central to the urgent public health challenges facing non-medical users of prescription opioids in the US, particularly in the context of evolving technologies and abuse-deterrent formulations to prevent injecting and opioid abuse. Taken together, the results of this work will inform the development of interventions to prevent injectin initiation and reduce HIV transmission in NMPO-using populations, and avert unintended adverse consequences of ongoing prescription opioid prescribing and policy changes.
Although the misuse and abuse of prescription opioids is an escalating public health problem in the United States, the epidemiology of non-medical prescription opioid use in young people and its relationship to initiation of injection drug use an HIV infection remain critically understudied. This research will address these knowledge gaps by evaluating risk factors for and trajectories into injection drug use among 200 young adult non-medical users of prescription opioids. The results of this study will help guide the development of interventions to prevent transitions to injecting and avert new cases of HIV and hepatitis C among opioid users, and improve the health of opioid-dependent young people.
|Bouvier, Benjamin A; Waye, Katherine M; Elston, Beth et al. (2018) Prevalence and correlates of benzodiazepine use and misuse among young adults who use prescription opioids non-medically. Drug Alcohol Depend 183:73-77|
|Soipe, Ayorinde I; Taylor, Lynn E; Abioye, Ajibola I et al. (2018) Prevalence of Hepatitis C Screening, Testing, and Care Experience Among Young Adults Who Use Prescription Opioids Nonmedically. J Adolesc Health 62:114-117|
|Liebling, Elliott J; Green, Traci C; Hadland, Scott E et al. (2018) Injection drug use and overdose among young adults who use prescription opioids non-medically. Addict Behav 76:20-26|
|Marshall, Brandon D L; Green, Traci C; Elston, Beth et al. (2018) The Effectiveness of Internet- and Field-Based Methods to Recruit Young Adults Who Use Prescription Opioids Nonmedically. Subst Use Misuse 53:1688-1699|
|Evans, Tristan I; Liebling, Elliott J; Green, Traci C et al. (2017) Associations Between Physical Pain, Pain Management, and Frequency of Nonmedical Prescription Opioid Use Among Young Adults: A Sex-specific Analysis. J Addict Med 11:266-272|
|Macmadu, Alexandria; Carroll, Jennifer J; Hadland, Scott E et al. (2017) Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically. Addict Behav 68:35-38|
|Bouvier, Benjamin A; Elston, Beth; Hadland, Scott E et al. (2017) Willingness to use a supervised injection facility among young adults who use prescription opioids non-medically: a cross-sectional study. Harm Reduct J 14:13|
|Carroll, Jennifer J; Marshall, Brandon D L; Rich, Josiah D et al. (2017) Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study. Int J Drug Policy 46:136-145|
|Liebling, Elliott J; Yedinak, Jesse L; Green, Traci C et al. (2016) Access to substance use treatment among young adults who use prescription opioids non-medically. Subst Abuse Treat Prev Policy 11:38|
|Yedinak, Jesse L; Kinnard, Elizabeth N; Hadland, Scott E et al. (2016) Social context and perspectives of non-medical prescription opioid use among young adults in Rhode Island: A qualitative study. Am J Addict 25:659-665|
Showing the most recent 10 out of 22 publications