Grant: Operating Grant

The incidence of sexually transmitted and blood-borne infections (STBBI) has reached alarming proportions in Québec. This is particularly true for hepatitis C (HCV) and HIV infections among intravenous drug users (IVDUs). The risk of injecting with used equipment has grown over the past five years largely due to increased consumption - by injection - of pharmaceutical opioids that are normally taken orally (e.g. Dilaudid®). It is well recognized that the abuse of prescription opioids is on the rise in North America. For example, the number of admissions related to OxyContin® abuse in Ontario increased steadily from 3.8% of admissions in 2000, to 55.4% of the total opioid admissions in 2004. Both illicit and prescription opiate abuse are major health issues in Canada. Increasing levels of prescription opioid abuse coupled with increased heroin availability and the rising rates of STTBI make it essential to provide effective and efficient treatment for opiate dependence. Unfortunately, opiate dependence is the most intractable substance use disorder to treat. Opiate dependent patients have poorer engagement in treatment, shorter treatment stays and poorer outcomes compared to other substance related disorders. Further understanding of treatment failure is a critical clinical and research issue.