Young adults use intravenous opioids to treat psychological symptoms – results from a cross-sectional survey

Background Opioid use among young adults is a global public health issue with an alarming need for comprehensive prevention and treatment strategies. This study contributes novel insights into the reasons for opioid use across different age and gender groups, and the reasons why opioid users had not sought opioid maintenance treatment (OMT).Methods An anonymous electronic survey was deployed at 16 health counseling units offering needle exchange across Finland.Results Among 167 adult respondents, 62% were men and 14% under the age of 25. The median age at starting illegal drug use was 17–18 years and intravenous drug use had started just a few years later (median 19–20 years). Among those under 25 years, the most common self-reported reason for opioid use was self-treatment of psychological symptoms, and they often used buprenorphine with other sedative substances. The most common reason for young respondents’ unwillingness to seek OMT was fear of authority action.Conclusions Intravenous use often begins relatively soon after the first drug-taking experiences, and buprenorphine is often used concomitantly with other substances that increase the risk of death by poisoning. With opioid users of all ages, the threshold for treatment referrals should be as low as possible.