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Logistic regression and Cox regression were used to identify factors associated with life\u2010time injection drug use and transition time to injection, respectively.<\/jats:p><jats:p><jats:bold>Findings\u2003<\/jats:bold> OxyContin<jats:sup>\u00ae<\/jats:sup> was involved in nearly as many initiations to injection (48%), as were stimulants, other prescription opioids and heroin combined; for participants who initiated with OxyContin<jats:sup>\u00ae<\/jats:sup>, the median time from which they began OxyContin<jats:sup>\u00ae<\/jats:sup> use to their first injection of OxyContin<jats:sup>\u00ae<\/jats:sup> was 3 years. Adjusting for demographics, five prescription drugs (benzodiazepines, illicit methadone, oxycodone, OxyContin<jats:sup>\u00ae<\/jats:sup> and other opiates) were associated with an increased hazard for transitioning from first illicit drug use to first injection drug use (each at <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.01).<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> In Appalachia, in the United States, the prescription opioid OxyContin<jats:sup>\u00ae<\/jats:sup> is widely used non\u2010medically and appears to show a particularly high risk of rapid transition to injection compared with the use of other illicit drugs.<\/jats:p>","DOI":"10.1111\/j.1360-0443.2011.03635.x","type":"journal-article","created":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T03:53:24Z","timestamp":1314849204000},"page":"587-596","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":119,"title":["Transition from first illicit drug use to first injection drug use among rural Appalachian drug users: a cross\u2010sectional comparison and retrospective survival analysis"],"prefix":"10.1111","volume":"107","author":[{"given":"April M.","family":"Young","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Havens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,26]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"Substance Abuse and Mental Health Services Administration.The NSDUH Report: Injection Drug Use And Related Risk Behaviors. 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