Changes in illicit opioid use across Canada. medicale canadienne

摘要

For almost a century, heroin addiction has been a core element of the illicit drug use problem in Canada. According to recent data, there are an estimated 125 000 injection drug users in Canada, most of whom use heroin and cocaine. Heroin addiction is associated with a variety of harms, including death, morbidity and crime. There are many examples of these harms: the number of overdose-related deaths in British Columbia rose dramatically from 39 to 331 between 1988 and 1993; the majority of new cases of hepatitis C in Canada are related to illicit drug use; and most heroin addicts are involved in regular criminal activity. Considerable public resources are expended on heroin addiction. Canadian law enforcement agencies direct substantial expenditures to prevent heroin importation and distribution -albeit with limited success. On the health care side, the number of people receiving methadone maintenance treatment (the primary treatment response for heroin addiction) has increased 5 times since the mid-1990s, to about 25 000 spaces across Canada. Furthermore, alternative treatment options are in development, including buprenorphine maintenance and medical heroin treatment. In the past several years, there have been isolated reports of substantially increased levels of prescription opioid abuse in Canada, the United States and other jurisdictions. However, until now, its impact on usage patterns among street drug users in Canada has been unclear and not systematically documented.