Exploring Drug Sourcing among Regular Prescription Opioid Users in Canada: Data from Toronto and Victoria

Recent North American data document increased prescription opioid (PO) misuse in general and street-drug-user populations. One aspect of this phenomenon – as distinct from illicit drug use – appears to be sourcing, since POs may be obtained through various forms of diversion from the medical system and other sources. However, the overall function of street-drug markets for POs remains unclear. Regular street users of POs in Toronto (N = 43) and Victoria (N = 39) were recruited by community-based methods and completed an interviewer-administered questionnaire exploring features of PO sourcing from street-drug markets. Respondents were PO- and non-opioid poly-drug users, with few holding their own prescription for POs. Regular sources for POs were more common in Toronto. Sizeable proportions of respondents in both sites reported exchanging and selling illicit drugs, involving both PO and non-PO drugs in Toronto, yet mainly restricted to the latter in Victoria. Respondents suggested a possible demarcation line between street market sources for POs and street market sources for illicit drugs. The availability of, demand for, and prices for PO-drugs was observed to have increased in recent years. Street-drug markets appear to be one key source feeding increasing levels of PO use among street users. Our data suggest that there may be distinct market patterns for POs, findings which are important for developing interventions and future research.