Withdrawal ups health risks for persons who inject opioids

Article written by Bruce Sylvester

Symptoms of opioid withdrawal increase the odds that a drug-injecting person will share needles or have a non-fatal overdose..

..researchers reported on March 18, 2020  the journal Drug and Alcohol Dependence.

Symptoms of opioid withdrawal increase the odds that a drug-injecting person will share needles or have a non-fatal overdose, researchers reported on March 18, 2020  the journal Drug and Alcohol Dependence.

“Withdrawal is one of the main chronic health challenges for this population, and we need to be intervening on it,” said lead author Ricky Bluthenthal, PhD, associate dean for social justice at the Keck School of Medicine of University of Southern California in Los Angeles. “I suspect if we’re successful at that, then a lot of other things that can improve health in this population will be more readily achieved.”

As background, the authors noted that while opioid withdrawal symptoms are generally assumed to contribute to overdose risk among persons who inject drugs (PWID), that risk has not been rigorously studied.

The investigators used targeted sampling methods to recruit 814 PWID frequent opioid users (at least 12 uses in the last 30 days). They were interviewed about demographics, drug use, health risk, withdrawal symptoms, frequency, and pain.

The researchers used standard statistical tools to analyse factors related to opioid withdrawal, withdrawal frequency, pain severity, and two important health risks — receptive syringe sharing and non-fatal overdose.

Eighty-five per cent of the subjects reported opioid withdrawal symptoms in the last 6 months, with 29 % reporting at least monthly symptoms and 35 % reporting at least weekly symptoms.

Fifty-seven per cent of the subjects reported very or extremely painful symptoms.

The investigators reported that any opioid withdrawal and weekly or more opioid withdrawal were significantly associated with receptive syringe sharing.

Any opioid withdrawal was independently and significantly associated with nonfatal overdose..

They also found that weekly or more withdrawal frequency and extreme or very painful withdrawal symptoms were associated with nonfatal overdose.

The authors concluded, “Withdrawal symptoms among PWID increase health risk. Treatment of withdrawal symptoms is urgently needed and should include buprenorphine dispensing.”

“Opioid withdrawal is a common public health issue and it is rarely treated,” added Bluthenthal. “Knowing that 85% or so of the people who are chronic opiate users are going to experience withdrawal at some point in the near future and that we have medication to treat it, we should make it available for that purpose.”