............................................................................................................................... ii PREFACE .................................................................................................................................. iii TABLE OF CONTENTS ......................................................................................................... iv LIST OF TABLES ..................................................................................................................... vi LIST OF FIGURES ................................................................................................................. vii LIST OF ABBREVIATIONS ............................................................................................... viii ACKNOWLEDGMENTS ........................................................................................................ x DEDICATION .......................................................................................................................... xi 1. STUDY BACKGROUND, RATIONALE, AND OBJECTIVES ................................... 1 1.1. BACKGROUND .......................................................................................................................... 1 1.1.1. Prescription Opioids .................................................................................................... 1 1.1.2. Prescription Opioid Epidemic in North America .................................................... 2 1.1.3. Prescription Opioids and People who Inject Drugs ................................................ 4 Prescription Opioid Injection: Prevalence and Trends ........................................................ 4 People who Inject Drugs .......................................................................................................... 4 Prescription Opioid Injection: Known Associations and Knowledge Gaps ..................... 6 1.2. RATIONALE ................................................................................................................................ 7 1.3. FRAMEWORK ............................................................................................................................. 7 1.4. STUDY SETTING AND SAMPLE .......................................................................................... 9 1.4.1. Study Setting ................................................................................................................. 9 1.4.2. Study Sample ................................................................................................................ 9 1.5. OBJECTIVES .............................................................................................................................. 11 2. HEALTH OUTCOMES ASSOCIATED WITH ILLICIT PRESCRIPTION OPIOID INJECTION: A SYSTEMATIC REVIEW ........................................................................... 14 2.