Grant: CIHR New Investigator

In Canada, social costs due to substance abuse are estimated to approach $40 billion annually. Specifically, intravenous drug use, including illicit opioids (e.g., heroin) injection, is associated with an array of health and social harms for individuals and communities, including high rates of overdoses and infectious diseases via the sharing of injection equipment. Unfortunately, some of Canada's most vulnerable populations, including Aboriginal peoples, are hardest hit by these harms. While some interventions, including opioid substitution therapies (e.g., methadone maintenance therapy), have proven effective in reducing injection drug-related harms, Canada is now experiencing a new epidemic of prescription opioid (PO) misuse, and little is known about how existing interventions can be optimized to address rising PO misuse, particularly among people who inject drugs. While many opioid users are also known to use cocaine, there are no approved pharmacotherapies for the treatment of cocaine addiction, necessitating urgent research efforts in this area. Lastly, while provinces have recently initiated new opioid addiction-related services, the impact of new service delivery models on PO misuse and other drug-related harms have not been fully evaluated. My proposed research builds on my past work focused on illicit drug use and aims to reduce healthcare costs and improve health by focusing on PO misuse and polydrug users (i.e., users of opioids and cocaine). Specifically, my primary research objectives are: (1) to investigate and address the impact of emerging PO misuse and concomitant crack cocaine use on patterns of injection drug use and drug-related harm; (2) to evaluate the efficacy of a novel addiction treatment option to treat polydrug users; and (3) to evaluate the impact of new structural interventions that are relevant to polydrug users.