Prescription opioid injection and HCV among young injection drug users

Background. Incidence of hepatitis C virus (HCV) has increased among young adults over the past 10 years. During this same period, misuse of prescription opioids (PO) has risen among young adults. This analysis compares young injection drug users (IDUs) who have ever injected PO with young IDUs who have not to determine negative health outcomes associated with injecting PO, including HCV.

Methodology. Young IDUs were recruited in New York and Los Angeles between 2009-11. Eligible participants had misused any prescription drug at least three times in the past three months. A total of 253 young adults who had ever injected drugs qualified for study enrollment. Multivariate analysis focused on factors associated with ever injecting PO, including patterns of drugs use, syringe sharing, and HCV.

Results. A greater proportion of the sample had ever injected PO (60.9%) compared to those who had not (39.1%). Key factors associated with PO injection included: current IDU; ever incarcerated; and ever injected crack cocaine. PO injectors had greater odds of sharing syringes in the past three months compared to non-PO injectors. 70.2% of PO self-reported as being HCV positive compared to 29.8% of non-PO injectors. In a final multivariate model, HCV was associated with crack injection and recent syringe sharing but not PO injection.

Conclusions. Prevalence of HCV and ever injecting PO and crack was high among this sample. Increasing incidence of HCV among young IDUs may be linked to less common drug using practices, such as injecting crack and PO in some cases.