Background: Nonmedical prescription opioid use has emerged as a major public health concern in recent years,\r\nparticularly in rural Appalachia. Little is known about the routes of administration (ROA) involved in nonmedical\r\nprescription opioid use among rural and urban drug users. The purpose of this study was to describe rural-urban\r\ndifferences in ROA for nonmedical prescription opioid use.\r\nMethods: A purposive sample of 212 prescription drug users was recruited from a rural Appalachian county\r\n(n = 101) and a major metropolitan area (n = 111) in Kentucky. Consenting participants were given an intervieweradministered\r\nquestionnaire examining sociodemographics, psychiatric disorders, and self-reported nonmedical use\r\nand ROA (swallowing, snorting, injecting) for the following prescription drugs: buprenorphine, fentanyl,\r\nhydrocodone, hydromorphone, methadone, morphine, OxyContin�® and other oxycodone.\r\nResults: Among urban participants, swallowing was the most common ROA, contrasting sharply with substancespecific\r\nvariation in ROA among rural participants. Among rural participants, snorting was the most frequent ROA\r\nfor hydrocodone, methadone, OxyContin�®, and oxycodone, while injection was most common for hydromorphone\r\nand morphine. In age-, gender-, and race-adjusted analyses, rural participants had significantly higher odds of\r\nsnorting hydrocodone, OxyContin�®, and oxycodone than urban participants. Urban participants had significantly\r\nhigher odds of swallowing hydrocodone and oxycodone than did rural participants. Notably, among rural\r\nparticipants, 67% of hydromorphone users and 63% of morphine users had injected the drugs.\r\nConclusions: Alternative ROA are common among rural drug users. This finding has implications for rural\r\nsubstance abuse treatment and harm reduction, in which interventions should incorporate methods to prevent\r\nand reduce route-specific health complications of drug use.
Loading....