Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers- United States, 2002-2004 and 2008-2010
Abstract
Background Heroin use and overdose deaths have increased in recent years. Emerging information suggests this is the result of increases in nonmedical use of opioid pain relievers and nonmedical users transitioning to heroin use. Understanding this relationship is critically important for the development of public health interventions.Methods Combined data from the 2002-2004 National Surveys on Drug Use and Health were compared to the 2008-2010 surveys to examine patterns of heroin use and risk behaviors among past year nonmedical users of opioid pain relievers.Results Between 2002-2004 and 2008-2010, past year heroin use increased among people reporting past year nonmedical use (PYNMU) of opioid pain relievers (p<0.01), but not among those reporting no PYNMU. Frequent nonmedical users - people reporting 100-365 days of PYNMU - had the highest rate of past year heroin use and were at increased risk for ever injecting heroin (aOR 4.3, 95% CI 2.5-7.3) and past year heroin abuse or dependence (aOR 7.8, 95% CI 4.7-12.8) compared to infrequent nonmedical users (1-29 days of PYNMU). In 2008-2010, 82.6% of frequent nonmedical users who used heroin in the past year reported nonmedical use of opioid pain relievers prior to heroin initiation compared to 64.1% in 2002-2004.Conclusions Heroin use among nonmedical users of opioid pain relievers increased between 2002-2004 and 2008-2010, with most reporting nonmedical use of opioid pain relievers before initiating heroin. Interventions to prevent nonmedical use of these drugs are needed and should focus on high-risk groups such as frequent nonmedical users of opioids.
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As many as 80% of heroin users started with prescription opioids.
“Other research has shown that as many as 80% of heroin users started with prescription opioids (32).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [32]
Cites
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,769 · see citing works
Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., Donovan, M. I., Fishbain, D. A., Foley, K. M., Fudin, J., et al. (2009) · The Journal of Pain · doi:10.1016/j.jpain.2008.10.008 · Cited by 2,192 · see citing works
Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008.
Paulozzi, L. J., Jones, C. M., Mack, K. A., & Rudd, R. A. (2011) · PubMed · Cited by 1,350 · see citing works
Self-citationMcGuire, S. (2014) · Advances in Nutrition · doi:10.3945/an.114.007211 · Cited by 1,122 · see citing works
Risk Factors for Human Immunodeficiency Virus Infection in Intravenous Drug Users
Schoenbaum, E. E., Hartel, D. M., Selwyn, P. A., Klein, R. S., Davenny, K., Rogers, M., Feiner, C., & Friedland, G. H. (1989) · New England Journal of Medicine · doi:10.1056/nejm198909283211306 · Cited by 494 · see citing works
Initiation into prescription opioid misuse amongst young injection drug users
Lankenau, S. E., Teti, M., Silva, K., Bloom, J. J., Harocopos, A., & Treese, M. (2012) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2011.05.014 · Cited by 440 · see citing works
Becker, W. C., Sullivan, L. E., Tetrault, J. M., Desai, R. A., & Fiellin, D. A. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.09.018 · Cited by 398 · see citing works
Effect of Abuse-Deterrent Formulation of OxyContin
Cicero, T. J., Ellis, M. S., & Surratt, H. L. (2012) · New England Journal of Medicine · doi:10.1056/nejmc1204141 · Cited by 337 · see citing works
Community-Based Opioid Overdose Prevention Programs Providing Naloxone —United States, 2010
Wheeler, E., Davidson, P. J., Jones, T. S., & Irwin, K. S. (2012) · JAMA · doi:10.1001/jama.307.13.1358 · Cited by 257 · see citing works
Gender and prescription opioids: Findings from the National Survey on Drug Use and Health
Back, S. E., Payne, R. L., Simpson, A. N., & Brady, K. T. (2010) · Addictive Behaviors · doi:10.1016/j.addbeh.2010.06.018 · Cited by 240 · see citing works
Prescription opioid abuse among enrollees into methadone maintenance treatment
Rosenblum, A., Parrino, M. W., Schnoll, S. H., Fong, C., Maxwell, C., Cleland, C. M., Magura, S., & Haddox, J. D. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.02.012 · Cited by 231 · see citing works
Evolving Epidemiology of Hepatitis C Virus in the United States
Klevens, R. M., Hu, D. J., Jiles, R., & Holmberg, S. D. (2012) · Clinical Infectious Diseases · doi:10.1093/cid/cis393 · Cited by 214 · see citing works
Prescription opioid abuse in patients presenting for methadone maintenance treatment
Brands, B., Blake, J. E., Sproule, B. A., Gourlay, D. L., & Busto, U. E. (2003) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2003.10.012 · Cited by 190 · see citing works
Illicit use of opioids: is OxyContin a “gateway drug”?
Grau, L. E., Dasgupta, N., Harvey, A. P., Irwin, K., Givens, A., Kinzly, M. L., & Heimer, R. (2007) · The American Journal on Addictions · doi:10.1080/10550490701375293 · Cited by 177 · see citing works
Gender and non‐medical use of prescription opioids: results from a national US survey*
Tetrault, J. M., Desai, R. A., Becker, W. C., Fiellin, D. A., Concato, J., & Sullivan, L. E. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.02056.x · Cited by 168 · see citing works
Prescription opioid use, misuse, and diversion among street drug users in New York City
Davis, W. R., & Johnson, B. D. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.08.008 · Cited by 161 · see citing works
(2010) · PsycEXTRA Dataset · doi:10.1037/e515452011-001 · Cited by 158 · see citing works
Moore, B. A., Fiellin, D. A., Barry, D. T., Sullivan, L. E., Chawarski, M. C., O’Connor, P. G., & Schottenfeld, R. S. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0129-0 · Cited by 155 · see citing works
Young, A. M., & Havens, J. R. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03635.x · Cited by 143 · see citing works
Petróczi, A., & Nepusz, T. (2011) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/1747-597x-6-1 · Cited by 135 · see citing works
Prevalence of opioid analgesic injection among rural nonmedical opioid analgesic users
Havens, J. R., Walker, R., & Leukefeld, C. G. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2006.07.008 · Cited by 130 · see citing works
Peavy, K. M., Banta‐Green, C. J., Kingston, S., Hanrahan, M. T., Merrill, J. O., & Coffin, P. O. (2012) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2012.704591 · Cited by 128 · see citing works
National Drug Threat Assessment 2011
(2011) · PsycEXTRA Dataset · doi:10.1037/e618352012-001 · Cited by 104 · see citing works
Prescription OxyContin abuse among patients entering addiction treatment.
Carise, D., Dugosh, K. L., Mclellan, A., Camilleri, A. C., Woody, G. E., & Lynch, K. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07050252 · Cited by 98 · see citing works
Route of drug use and its implications for drug effect, risk of dependence and health consequences
Strang, J., Bearn, J., Farrell, M., et al. (1998) · Drug and Alcohol Review · doi:10.1080/09595239800187001 · Cited by 96 · see citing works
Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain
Rolfs, R. T., Johnson, E., Williams, N. J., & Sundwall, D. N. (2010) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2010.503265 · Cited by 71 · see citing works
Notes from the field : hepatitis C virus infections among young adults--rural Wisconsin, 2010.
(2012) · PubMed · Cited by 63 · see citing works
Substance use histories in patients seeking treatment for controlled-release oxycodone dependence
Potter, J. S., Hennessy, G., Borrow, J., et al. (2004) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2004.05.001 · Cited by 61 · see citing works
Daniulaityte, R., Carlson, R. G., & Kenne, D. R. (2006) · Journal of Drug Issues · doi:10.1177/002204260603600402 · Cited by 61 · see citing works
(2011) · PubMed · Cited by 55 · see citing works
Frequency of Prescription Pain Reliever Nonmedical Use: 2002-2003 and 2009-2010
Jones, C. M. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.2533 · Cited by 53 · see citing works
Self-citationPrescription Opioid Use Among Patients Seeking Treatment for Opioid Dependence
Canfield, M. C., Keller, C. E., Frydrych, L. M., et al. (2010) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e3181b5a713 · Cited by 44 · see citing works
Prevalence and Patterns of Prescription Drug Misuse among Young Ketamine Injectors
Lankenau, S. E., Sanders, B., Bloom, J. J., Hathazi, D., Alarcon, E., Tortu, S., & Clatts, M. C. (2007) · Journal of Drug Issues · doi:10.1177/002204260703700311 · Cited by 39 · see citing works
Cleland, C. M., Rosenblum, A., Fong, C., et al. (2011) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/1747-597x-6-11 · Cited by 29 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Han, B., Compton, W. M., Blanco, C., Crane, E., Lee, J., & Jones, C. M. (2017) · Annals of Internal Medicine · doi:10.7326/m17-0865 · Cited by 873 · see citing works
Self-citationNational and state treatment need and capacity for opioid agonist medication-assisted treatment
Jones, C. M., Campopiano, M., Baldwin, G., & McCance-Katz, E. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302664 · Cited by 668 · see citing works
Self-citationStrang, J., Volkow, N. D., Degenhardt, L., Hickman, M., Johnson, K., Koob, G. F., Marshall, B. D. L., Tyndall, M., & Walsh, S. L. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0137-5 · Cited by 639 · see citing works
Han, B., Compton, W. M., Jones, C. M., & Cai, R. (2015) · JAMA · doi:10.1001/jama.2015.11859 · Cited by 366 · see citing works
Self-citationDowell, D., Zhang, K., Noonan, R. K., & Hockenberry, J. M. (2016) · Health Affairs · doi:10.1377/hlthaff.2016.0448 · Cited by 264 · see citing works
Cicero, T. J., & Ellis, M. S. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.3043 · Cited by 237 · see citing works
Saha, T. D., Kerridge, B. T., Goldstein, R. B., Chou, S. P., Zhang, H., Jung, J., Pickering, R. P., Ruan, W. J., Smith, S. M., Huang, B., et al. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15m10386 · Cited by 222 · see citing works
Prescription opioid exposures among children and adolescents in the United States: 2000–2015.
Allen, J. D., Casavant, M. J., Spiller, H. A., Chounthirath, T., Hodges, N. L., & Smith, G. A. (2017) · Pediatrics · doi:10.1542/peds.2016-3382 · Cited by 156 · see citing works
Opioid misuse in gastroenterology and non-opioid management of abdominal pain
Szigethy, E., Knisely, M., & Drossman, D. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.141 · Cited by 117 · see citing works
Noble, F., & Marie, N. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00742 · Cited by 56 · see citing works
Ford, J. A., Sacra, S. A., & Yohros, A. (2017) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2017.05.001 · Cited by 54 · see citing works
Smith, K. Z., Smith, P. H., Cercone, S. A., McKee, S. A., & Homish, G. G. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.02.019 · Cited by 48 · see citing works
The pain reliever and heroin epidemic in the United States: shifting winds in the perfect storm
Maxwell, J. C. (2015) · Journal of Addictive Diseases · doi:10.1080/10550887.2015.1059667 · Cited by 44 · see citing works
A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health
Wiss, D. A. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00193 · Cited by 41 · see citing works
Trends and key correlates of prescription opioid injection misuse in the United States
Jones, C. M. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.10.018 · Cited by 37 · see citing works
Self-citationHealth behaviors of young adult heroin injectors in the Seattle area.
Cedarbaum, E. R., & Banta-Green, C. J. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.11.011 · Cited by 34 · see citing works
Pain acceptance and opiate use disorders in addiction treatment patients with comorbid pain
Lin, L. (., Bohnert, A. S. B., Price, A. M., Jannausch, M., Bonar, E. E., & Ilgen, M. A. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.10.017 · Cited by 20 · see citing works
Trait Mindfulness and Progression to Injection Use in Youth With Opioid Addiction
Wilson, J. D., Vo, H., Matson, P., Adger, H., Barnett, G., & Fishman, M. (2017) · Substance Use & Misuse · doi:10.1080/10826084.2017.1289225 · Cited by 14 · see citing works
- Authors
- Jones, C. M.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Jones, Christopher M.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 132
- Issue
- 1-2
- Pages
- 95-100
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2025653942
- Cited by
- 517
- References
- 34
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 14 · 2023: 28 · 2022: 25 · 2021: 38 · 2020: 76 · 2019: 75 · 2018: 65 · 2017: 68 · 2016: 40 · 2015: 43 · 2014: 20 · 2013: 4
- FWCI
- 36.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- heroin use, opioid misuse, heroin addiction, heroin abuse, opioid overdose deaths, risk-taking, temporal trends, National Survey on Drug Use and Health
- MeSH terms
- Adolescent, Adult, Analgesics, Opioid, Child, Female, Health Surveys, Heroin Dependence, Humans, Male, Opioid-Related Disorders, Risk, Socioeconomic Factors, United States, Age of Onset, Young Adult, Prescription Drug Misuse, Prescription Drug Diversion
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