Binge Drug Injection in a Cohort of People Who Inject Drugs in Montreal: Characterizing the Substances and Social Contexts Involved

We describe binge drug injection in a longitudinal cohort study of people who inject drugs (PWID) in Montreal, Canada (eligibility: age ≥ 18, past-6-month injection drug use; follow-up: 3-monthly interviews). Bingeing was defined as injecting large quantities of drugs over a limited period, until participants ran out or were unable to continue, in the past 3 months. We recorded substances and circumstances typically involved in binge episodes. Eight hundred five participants (82% male, median age 41) provided 8158 observations (2011–2020). Thirty-six per cent reported bingeing throughout follow-up. Binges involved a diverse range of substances and social contexts. Cocaine was involved in a majority of recent binges (73% of visits). Injection of multiple drug classes (24% of visits) and use of non-injection drugs (63% of visits) were common, as were opioid injection (42%) and injecting alone (41%). Binge drug use may thus be an important yet overlooked trigger of overdose and other harms among PWID. This understudied high-risk behavior warrants further research and public health attention.