Association of Nonmedical Prescription Opioid Use With Subsequent Heroin Use Initiation in Adolescents

Objective: This study examined the means of obtainment, indication, and prescriber of an index opioid in self-reporting heroin users.Design: Cross-sectional, observational study.Setting: A survey was submitted by participants in the United States with current or past heroin use.Participants: Three hundred twenty-three participants greater than 18 years of age completed the survey.Main outcome measure: Participants were surveyed regarding prescription opioid use prior to heroin initiation and specifically how they were obtained. Surveys were comprehensive in nature, divulging information including which opioid(s) was/were used, how they were obtained, by which prescriber (if prescribed), and if there was a diagnosis for chronic pain.Results: Roughly 47 percent of participants reported using prescription opioids prior to heroin. The most commonly used prescription opioid prior to heroin initiation was oxycodone (92.5 percent). The most common acquisition of opioids was through the prescribing of a physician, which occurred in roughly 63 percent of cases. These prescriptions were obtained most often from primary care physicians and emergency departments. Only 34 percent of participants reported being diagnosed with a chronic pain condition prior to using heroin.Conclusions: This study further supports the role that prescription opioids play in the transition to heroin use. It suggests that oxycodone is the most common prescription opioid used prior to heroin initiation. Additionally, it reports descriptive information as to how and where prescription opioids are obtained.

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Analyzing the relationship between nonmedical prescription-opioid use and heroin use

Journal of Opioid Management ◽

10.5055/jom.2016.0315 ◽

2016 ◽

Vol 12 (1) ◽

pp. 11 ◽

Cited By ~ 2

Author(s):

Xiulu Ruan, MD ◽

Melville Q. Wyche, III, MD ◽

Alan David Kaye, MD, PhD

Keyword(s):

Prescription Opioid ◽

Opioid Use ◽

Heroin Use ◽

Prescription Opioid Use ◽

The Relationship

No abstract

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Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007–2014

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2018.01.001 ◽

2018 ◽

Vol 87 ◽

pp. 79-85 ◽

Cited By ~ 45

Author(s):

Jeanne C. Marsh ◽

Keunhye Park ◽

Yu-An Lin ◽

Cliff Bersamira

Keyword(s):

Gender Differences ◽

Prescription Opioid ◽

Opioid Use ◽

Heroin Use ◽

Prescription Opioid Use

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Adverse Childhood Experiences Predict Early Initiation of Opioid Use Behaviors

Frontiers in Sociology ◽

10.3389/fsoc.2021.620395 ◽

2021 ◽

Vol 6 ◽

Author(s):

Honoria Guarino ◽

Pedro Mateu-Gelabert ◽

Kelly Quinn ◽

Skultip Sirikantraporn ◽

Kelly V. Ruggles ◽

...

Keyword(s):

Substance Use ◽

Adverse Childhood Experiences ◽

Early Initiation ◽

Prescription Opioid ◽

Opioid Use ◽

Medical Prescription ◽

Childhood Experiences ◽

Heroin Use ◽

Adverse Childhood ◽

Prescription Opioid Use

Introduction: Although a substantial body of research documents a relationship between traumatic stress in childhood and the initiation of substance use later in the life course, only limited research has examined potential linkages between adverse childhood experiences (ACEs) and the initiation of non-medical prescription opioid use and other opioid use behaviors. The present study contributes to this growing body of work by investigating the association of childhood trauma with early initiation of a series of opioid use behaviors.Methods: New York City young adults (n = 539) ages 18–29 who reported non-medical use of prescription opioids or heroin use in the past 30 days were recruited using Respondent-Driven Sampling in 2014–16. Ten ACEs were assessed via self-report with the ACE Questionnaire. Associations between number of ACEs and self-reported ages of initiating seven opioid use behaviors (e.g., non-medical prescription opioid use, heroin use, heroin injection) were estimated with multivariable logistic regression.Results: Eighty nine percent of participants reported at least one ACE, and 46% reported four or more ACEs, a well-supported threshold indicating elevated risk for negative health consequences. Every increase of one trauma was associated with a 12–23% increase in odds of early initiation across the seven opioid use behaviors. Findings also document that the mean age at initiation increased with increasing risk severity across the behaviors, contributing to evidence of a trajectory from opioid pill misuse to opioid injection.Discussion: Increasing number of childhood traumas was associated with increased odds of earlier initiation of multiple opioid misuse behaviors. In light of prior research linking earlier initiation of substance use with increased substance use severity, present findings suggest the importance of ACEs as individual-level determinants of increased opioid use severity. Efforts to prevent onset and escalation of opioid use among at-risk youth may benefit from trauma prevention programs and trauma-focused screening and treatment, as well as increased attention to ameliorating upstream socio-structural drivers of childhood trauma.

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