Prescription drug misuse among young injection drug users: Findings from New York and Los Angeles

Introduction: Misuse of prescription drugs, such as opioids, tranquilizers, and stimulants, has been increasing in the United States over the past decade. While young injection drug users (IDUs) are at increased risk for misuse of prescription drugs, few studies have examined patterns of prescription drug misuse among this population. Methods: During 2009-10, a total of 199 IDUs with a recent history of prescription drug misuse were recruited in New York (n=99) and Los Angeles (n=100). IDUs were administered a structured survey focusing on recent and lifetime patterns of misuse of prescription and illicit drugs. Findings: IDUs reported extensive histories of prescription and illicit drug misuse. Opioids were the second most commonly injected drug after heroin (68% vs. 86%, respectively). In the past 30 days, misuse of opioids (74%) and tranquilizers (68%) via any mode of administration, e.g., oral, sniffing, was more common than injecting opioids (31%) or tranquilizers (8%). Recent misuse of prescription drugs was less common than heroin (85%) but more typical than cocaine (43%) or methamphetamine (48%). Most had misused their own opioid (83%), tranquilizer (74%), or stimulant (69%) prescription. Only 30% of IDUs had ever been in methadone or suboxone drug treatment programs, while 32% reported currently having health insurance. Conclusions: Current misuse of opioids and tranquilizers were more typical than misuse of most illicit drugs, such as cocaine and methamphetamines. Unlike heroin, IDUs often consume prescription opioids via modes other than injection. Prescription drugs are an integral feature of patterns of drug use among young IDUs.