Sector News

  1. Perceived Risk of Opioid Overdose

    Background

    Globally, opioid use is on the rise. Opioid dependence is estimated as the largest contributor to the global burden of disease from drug dependence. In the United Stated, over 25 million people began using nonmedical opioids between 2002 and 2011. During this time, the drug-poisoning mortality rate more than doubled.

    Method

    The authors surveyed 172 opioid users in San Francisco to assess predictors of risk perception for opioid overdose.

    Findings

    • Older individuals and those who injected more frequently were less likely to see themselves at a high risk for opioid overdose. However, the literature indicates that those who are older are actually more likely to die from overdose.
    • Those who injected more frequently were less likely to perceive themselves as high risk for overdose.
    • Interestingly, although concurrent use of opioids and alcohol was associated with a high-perceived risk of overdose, concurrent use of opioids and benzodiazepines or cocaine was not. Yet previous research shows that concurrent use of these substances is linked to opioid overdose.
    • Participants who experienced a past overdose, used heroin and mixed opioids and alcohol more frequently were more likely to see themselves as high risk for overdose. This finding is consistent with the literature, which shows previous overdose to be the strongest predictor of overdose and overdose death.
    • HCV positive participants were more likely perceive themselves at high risk for overdose. However this association was not found amongst HIV positive participants, despite the risks. This suggests a gap in risk perception amongst this particular population.

    Conclusion

    There are gaps in awareness between real overdose risk factors and perceived overdose risk amongst opioid users. The authors highlight the need for educational interventions.

    Rowena, C., Santos, G.M., Behar, E., and Coffin P.O. (2016). Correlates of overdose risk perception among illicit opioid users. Drug and Alcohol Dependence. 159: 234-239.

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    HCV Among People Who Inject Drugs in Rural Puerto Rico

    Background

    Although we know that the microbial differences between HIV and HCV have an impact on prevalence, how drugs are obtained and used may also influence prevalence. Recent studies show Puerto Rico has one of the highest HCV prevalence rates in the world.

    Aim

    The authors looked risk factors of 315 rural Puerto Rican people who inject drugs (PWID) and also compared the behaviours of HCV negative and HCV positive participants.

    Method

    INSTI Rapid HIV and OraQuick Rapid tests were used to determine HIV and HCV status. Additional data was acquired through questionnaires.

    Findings

    • Over three quarters (78.4%) of the participants were positive for HCV and significantly fewer (6.0%) were HIV positive.
    • All HIV positive individuals were also infected with HCV.
    • Both HCV positive and HCV negative reported the same frequency of injection drug use during the last year.
    • Each additional person who used equipment before the participant was associated with an increase 18% increase in the odds of being HCV + positive.
    • Frequency of injection with a used cooker was over twice as common as injection with a used needle.

    HCV + (pos) Characteristics

    • 3 years older (than HCV negative)
    • Began injecting at a younger age (20.7 vs 26.3)
    • Injected for 9.4 more years than HCV negative group
    • Used cookers, cotton and water after an average of 2 or more people

    Conclusion

    This adds to current research showing that a notable proportion of HCV infections are due to cooker or cotton sharing.

    Abadie, R., Welch-Lazoritz, M., Gelepi-Acosta, C., Reyes, J.C., and Dombrowski, K. (2016). Understanding differences in HIV/HCV prevalence according to differentiated risk behaviors in a sample of PWID in rural Puerto Rico. Harm Reduction Journal. 13:10-13.