Differences in time to injection onset by drug in California: Implications for the emerging heroin epidemic

Drug and Alcohol Dependence
Ricky N BluthenthalAlex H Kral

Abstract

Heroin use is increasing in the US. Heroin use may predispose users towards injection routes of drug administration as compared to other illicit substances. To explore the relationship between heroin use and drug injection, we compared time from first use to first injection (referred to as time to injection onset by drug [TTIOD]) of heroin, methamphetamine/speed, cocaine, and crack cocaine among people who inject drugs (PWID). Age of first use and first injection by drug was collected from 776 PWID. Survival analyses were used to determine TTIOD and to examine demographic factors associated with TTIOD. Cox regression analysis was used to determine demographic factors associated with drug-specific injection onset. The eventual injection onset rate by the drug was 99% for participants who used heroin, 85% for participants who used methamphetamine/speed, 80% for participants who used powder cocaine, and 38% for participants who used crack cocaine. Hazard ratios for injection use within one year of first use by drug were: 1.37 (median survival time [MST] = 0.61 years) for heroin, 0.66 (MST = 1.10 years) for methamphetamine/speed, 0.50 (MST = 2.93 years) for powder cocaine, and 0.12 (MST = 39.59 years) for crack cocaine. Demographic...Continue Reading

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Citations

Feb 5, 2019·Health Affairs·David PowellRosalie L Pacula
Aug 11, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elizabeth R StevensR Scott Braithwaite
Aug 17, 2020·Journal of Psychoactive Drugs·Matthew McLaughlinAbigail Batchelder
Mar 19, 2021·American Journal of Public Health·Deborah HoltzmanSarah Schillie

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