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Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting Klimas, Jan; Mok, Wing Yin; Lake, Stephanie L.; Socias, M. Eugenia; DeBeck, Kora; Hayashi, Kanna; Wood, Evan; Milloy, M-J

Abstract

Background. While preliminary evidence has begun to document intentional use of one substance to reduce the use of another, the phenomenon of drug substitution among people who use illicit opioids remains understudied. Therefore, we sought to estimate the prevalence and correlates of intentional substance use to reduce illicit opioid use among persons who use drugs (PWUD). Methods. We analysed data from three prospective cohorts of PWUD in Vancouver, Canada, using multivariable generalized estimating equations (GEE). Results. Between June 2012 and June 2016, 1527 participants were recruited and contributed 4991 interviews. Of those, 336 (22%) illicit opioid-using participants self-reported substitution to reduce illicit opioid use at least once during study period contributing 467 (9.4%) interviews. Among those interviews, substances substituted for opioids were alcohol (15 participants, 3.2%), stimulants (235, 50.3%), cannabis (129, 27.6%), benzodiazepines (21, 4.5%), and others (20, 4.3%). In multivariable GEE model adjusted for socio-demographic factors, reporting substitution to reduce illicit opioid use was positively associated with greater likelihood of daily cannabis use (Adjusted Odds Ratio = 1.56, 95% Confidence Interval: 1.24–1.96]. Conclusions. While daily cannabis use was associated with reporting opioid substitution attempts, additional study is needed to examine potential of cannabis/cannabinoids to reduce illicit opioid use.

Item Metadata

Title
Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting
Creator
Klimas, Jan; Mok, Wing Yin; Lake, Stephanie L.; Socias, M. Eugenia; DeBeck, Kora; Hayashi, Kanna; Wood, Evan; Milloy, M-J
Contributor
British Columbia Centre on Substance Use; St. Paul's Hospital (Vancouver, B.C.)
Publisher
Taylor & Francis
Date Issued
2021-06-24
Description
Background. While preliminary evidence has begun to document intentional use of one substance to reduce the use of another, the phenomenon of drug substitution among people who use illicit opioids remains understudied. Therefore, we sought to estimate the prevalence and correlates of intentional substance use to reduce illicit opioid use among persons who use drugs (PWUD). Methods. We analysed data from three prospective cohorts of PWUD in Vancouver, Canada, using multivariable generalized estimating equations (GEE). Results. Between June 2012 and June 2016, 1527 participants were recruited and contributed 4991 interviews. Of those, 336 (22%) illicit opioid-using participants self-reported substitution to reduce illicit opioid use at least once during study period contributing 467 (9.4%) interviews. Among those interviews, substances substituted for opioids were alcohol (15 participants, 3.2%), stimulants (235, 50.3%), cannabis (129, 27.6%), benzodiazepines (21, 4.5%), and others (20, 4.3%). In multivariable GEE model adjusted for socio-demographic factors, reporting substitution to reduce illicit opioid use was positively associated with greater likelihood of daily cannabis use (Adjusted Odds Ratio = 1.56, 95% Confidence Interval: 1.24–1.96]. Conclusions. While daily cannabis use was associated with reporting opioid substitution attempts, additional study is needed to examine potential of cannabis/cannabinoids to reduce illicit opioid use.
Subject
cannabis; opioids; substance related disorders; longitudinal observation
Geographic Location
Downtown-Eastside (Vancouver, B.C.)
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2022-06-24
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0401209
URI
http://hdl.handle.net/2429/79181
Affiliation
Medicine, Faculty of; Non UBC; Medicine, Department of
Citation
Klimas, J., Mok, W. Y., Lake, S., Socías, M. E., DeBeck, K., Hayashi, K., Wood, E., Milloy, M-J. (2021) Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting. J Substance Use
Publisher DOI
10.1080/14659891.2021.1941341
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International