期刊
SUBSTANCE ABUSE
卷 43, 期 1, 页码 458-464出版社
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/08897077.2021.1946892
关键词
Fentanyl; overdose; drug preference; opioids; people who use drugs
资金
- US National Institute on Drug Abuse (NIDA) [R25-DA037756, U01DA038886, U01DA02152]
- Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine
- Canadian Institutes of Health Research (CIHR)
- Canadian Research Initiative on Substance Misuse [SMN-139148]
- NIDA [U01DA02152, U01-DA021525]
- CIHR New Investigator Award [MSH-141971]
- Michael Smith Foundation for Health Research (MSFHR) Scholar Award
- St. Paul's Foundation
- MSFHR Scholar Award
- National Institutes of Health
Despite the increasing prevalence of illicit fentanyl use in the US and Canada, preference for fentanyl over other illicit opioids has been on the rise among people who inject drugs, with younger age and daily crystal methamphetamine injection being independently associated with fentanyl preference.
Background: Despite increasing prevalence of illicit fentanyl use in the US and Canada, preference for fentanyl over other illicit opioids has not been fully characterized. Therefore, we sought to describe changes in illicit opioid preferences over time among people who inject drugs (PWID). Methods: Data were obtained from two prospective cohort studies between 2017 and 2018. Trends in opioid preference over time were examined using bivariable generalized estimating equation (GEE) analysis. Multivariable models were used to identify factors associated with fentanyl preference. Results: Among 732 eligible participants, including 425 (58%) males, the prevalence of preference for fentanyl increased from 4.4% in 2017 to 6.6% in 2018 (Odds Ratio [OR] = 1.27, 95% Confidence Interval [CI]: 1.05-1.52). In a multivariable analysis, younger age (Adjusted Odds Ratio [AOR] = 0.94, 95% CI: 0.92-0.96) and daily crystal methamphetamine injection (AOR = 1.68, 95% CI: 1.01-2.78) were independently associated with preference for fentanyl. The most common reasons for preferring fentanyl included better high than other opioids (45%), and lasts longer than heroin (27%). Conclusions: The current study has demonstrated that preference for fentanyl has been increasing over time among our sample of PWID who use opioids. Further work is needed to clarify risk factors surrounding transitions to illicit fentanyl.
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