Journal of Urban Health

, Volume 82, Issue 2, pp 250–266 | Cite as

Illicit opioid use in Canada: Comparing social, health, and drug use characteristics of untreated users in five cities (OPICAN study)

  • Benedikt FischerEmail author
  • Jürgen Rehm
  • Suzanne Brissette
  • Serge Brochu
  • Julie Bruneau
  • Nady El-Guebaly
  • Lina Noël
  • Mark Tyndall
  • Cameron Wild
  • Phil Mun
  • Dolly Baliunas


Most of the estimated 125,000 injection drug users (IDUs) in Canada use illicit opioids and are outside treatment (i.e., methadone maintenance treatment). Empirical data suggest that illicit opioid users outside treatment are characterized by various health and social problem characteristics, including polydrug use, physical and mental morbidity, social marginalization, and crime. Although required for evidence-based programming, systematic information on this specific substance-user population is sparse in Canada to date. This article presents and compares key characteristics of population of illicit opioid users outside treatment in five cities across Canada (OPICAN cohort). Overall, the majority of OPICAN participants regularly used both a variety of illicit opioids and cocaine or crack, reported physical and mental health (e.g., mood disorder) problems, lacked permanent housing, were involved in crime, and had their “ideal” treatment not available to them. However, key local sample differences were shown, including patterns of heroin versus prescription opioid use and levels of additional cocaine versus crack use as well as indicators of social marginalization. Illicit opioid user population across Canada differ on key social, health, and drug use indicators that are crucial for interventions and are often demonstrated between larger and smaller city sites. Differentiated interventions are required.


Canada Comorbidity Dependence Health Heroin use Illicit opioid use Infectious disease Methadone treatment Polydrug use Treatment 


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Copyright information

© Oxford University Press on behalf of the New York Academy of Medicine 2005

Authors and Affiliations

  • Benedikt Fischer
    • 1
    Email author
  • Jürgen Rehm
    • 1
  • Suzanne Brissette
    • 2
  • Serge Brochu
    • 3
  • Julie Bruneau
    • 2
  • Nady El-Guebaly
    • 4
  • Lina Noël
    • 5
  • Mark Tyndall
    • 6
  • Cameron Wild
    • 7
  • Phil Mun
    • 9
  • Dolly Baliunas
    • 8
  1. 1.University of Toronto and Centre for Addiction and Mental HealthTorontoCanada
  2. 2.Centre Hospitalier de l’Université de MontréalMontréalCanada
  3. 3.Université de MontréalMontréalCanada
  4. 4.Foothills HospitalCalgaryCanada
  5. 5.Institut Nationale de Santé Publique du QuébecBeauportCanada
  6. 6.BC Centre for Excellence in HIV/AIDSVancouverCanada
  7. 7.University of AlbertaEdmontonCanada
  8. 8.Centre for Addiction and Mental HealthTorontoCanada
  9. 9.Responsible Gambling CouncilTorontoCanada

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