Pharmaceutical Opioid Abuse among Suburban Drug Injectors

Opioid addiction often begins with abuse of pharmaceutical opioids (PO), but little is known about transitions to addiction, heroin use, and drug injection among PO abusers.  We recruited 462 injectors who reside in suburban communities in southwestern Connecticut and collected data on their past and present drug use, access to drug treatment and somatic disease prevention services, and experiences with the criminal justice system.  Among these individuals, all with a history of heroin injection, 376 had ever used POs, 153 had used and 63 had injected PO in the month prior to interview.  A history of PO use was associated with a greater likelihood of having been in drug treatment, but also a greater likelihood of have been denied treatment or having treatment prematurely interrupted.  PO use was also associated with an increased likelihood of having been arrested.  There was no difference in use of syringe exchange services that are located in the cities that the suburbs surround.  Current PO use was not associated with any of these treatment or criminal justice variables but was associated with currently experiencing chronic non-cancer pain that interferes with daily activities.  Regardless of PO use, 80% of those with chronic pain reported abusing opioids prior to the onset of pain.  These findings suggest that while the drug abuse trajectories of people have used PO in the past may differ from those who have not, current use of PO is only differential for those reporting chronic pain.