ArticleAddiction (Abingdon, England)2012
Transition from first illicit drug use to first injection drug use among rural Appalachian drug users: a cross-sectional comparison and retrospective survival analysis.
Article in Addiction (Abingdon, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04521920 (Providing Comprehensive Harm Reduction Via Telemedicine for PWID Using Syringe Services Programs), which is not on this map. Cited by 104 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Providing Comprehensive Harm Reduction Via Telemedicine for PWID Using Syringe Services Programs: a Feasibility Study
Who cites it
104 citing papers in PubMed, 5 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases.Substance abuse · 2020Pooled it
- Social norms associated with nonmedical opioid use in rural communities: a systematic review.Translational behavioral medicine · 2019Pooled it
- The epidemiology of benzodiazepine misuse: A systematic review.Drug and alcohol dependence · 2019Pooled it
- The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis.Addiction (Abingdon, England) · 2017Pooled it
- Transition to injecting drug use in Iran: A systematic review of qualitative and quantitative evidence.The International journal on drug policy · 2015Pooled it
- HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs.AIDS and behavior · 2018Trial
- Trial
- Buprenorphine Initiation and Linkage to Outpatient Buprenorphine do not Reduce Frequency of Injection Opiate Use Following Hospitalization.Journal of substance abuse treatment · 2016Trial
- Primary care-based buprenorphine taper vs maintenance therapy for prescription opioid dependence: a randomized clinical trial.JAMA internal medicine · 2014Trial
- Buprenorphine/naloxone and methadone maintenance treatment outcomes for opioid analgesic, heroin, and combined users: findings from starting treatment with agonist replacement therapies (START).Journal of studies on alcohol and drugs · 2013Trial
- Safer supply deprescribing during a toxic drug poisoning crisis in Vancouver, Canada.Drug and alcohol dependence · 2026Article
- Characterizing the Geography of Drug Use Networks and Behaviors Among People Who Inject Drugs in the Baltimore Metropolitan Region.AIDS and behavior · 2026Article
- Transitions from first drug use to illicit opioid and injection drug use in a multisite rural U.S. cohort of people who use drugs.Harm reduction journal · 2026Article
- Disruptions in Reward-Guided Decision-Making Functions Are Predictive of Greater Oral Oxycodone Self-Administration in Male and Female Rats.Biological psychiatry global open science · 2025Article
- Correlates of duration between initial drug use and first drug injection among people who inject drugs in Iran, 2020.BMC public health · 2025Article
- Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018-2020.AIDS and behavior · 2024Article
- Effects of Morphine on Gp120-induced Neuroinflammation Under Immunocompetent Vs. Immunodeficient Conditions.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2023Article
- The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis.Addiction science & clinical practice · 2022Article
- The effects of opioid policy changes on transitions from prescription opioids to heroin, fentanyl and injection drug use: a qualitative analysis.Substance abuse treatment, prevention, and policy · 2022Article
- Review
44 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
aimThe study's objectives were to characterize initiation of injection drug use, examine the independent association of specific substance use with injection drug use and determine factors associated with rates of transition from first illicit drug use to first injection among a sample of rural Appalachian drug users.
designInterview-administered questionnaires were administered to a sample of drug users recruited via respondent-driven sampling.
settingAppalachian Kentucky.
participantsInjection drug users (IDUs) (n = 394) and non-IDUs (n = 109). MEASUREMENTS: Data were collected on substance use and years from age at initiation of illicit substance use to 'event' (initiation of injection or date of baseline interview for non-IDUs). Logistic regression and Cox regression were used to identify factors associated with life-time injection drug use and transition time to injection, respectively.
findingsOxyContin(®) was involved in nearly as many initiations to injection (48%), as were stimulants, other prescription opioids and heroin combined; for participants who initiated with OxyContin(®), the median time from which they began OxyContin(®) use to their first injection of OxyContin(®) was 3 years. Adjusting for demographics, five prescription drugs (benzodiazepines, illicit methadone, oxycodone, OxyContin(®) and other opiates) were associated with an increased hazard for transitioning from first illicit drug use to first injection drug use (each at P < 0.01).
conclusionsIn Appalachia, in the United States, the prescription opioid OxyContin(®) is widely used non-medically and appears to show a particularly high risk of rapid transition to injection compared with the use of other illicit drugs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.