This study described the prevalence and risk factors for nonmedical prescription drug use (NMPD) among injection drug users (IDUs) recruited at syringe exchange programs (SEPs) in California. Interviews were conducted with 1,586 IDUs recruited from 24 SEPs across three annual cross-sections between 2001 and 2003. Any NMPD use in the past 6 months was reported by 17% of the sample. Factors independently associated with depressant use include recent participation in a drug treatment program, recent injection of heroin, and frequency of injection. Factors independently associated with opioid use include frequency of injection and history of incarceration. NMPD depressant use increased the odds of a nonfatal overdose in the past year. The authors' findings represent a first step toward creating an epidemiologic profile of NMPD use that may be useful for targeting the implementation of interventions that are effective in reducing overdoses, a significant cause of mortality among IDUs worldwide.
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