Pharmaceutical opioid analgesic and heroin dependence: how do treatment-seeking clients differ in Australia?
Open accessAbstract
Introduction and Aims. Non‐prescribed use of pharmaceutical opioid analgesics (POA) has been escalating internationally. In Australia, few studies have examined if POA users have similar characteristics and treatment needs to heroin users. The aim of this study was to compare those presenting for treatment where heroin versus POA were the primary drugs of concern. Design and Methods. A convenience sample of 192 treatment entrants were recruited from alcohol and drug treatment services in four Australian jurisdictions. A structured interview collected data on demographic characteristics, substance use, self‐perceived mental and physical health, crime and harms resulting from drug use. Multivariate analyses were performed to identify characteristics which may differentiate those seeking treatment for heroin compared with POA. Results. Most treatment entrants sampled reported a history of injection drug use and use of both heroin and POA. However, those with primary POA problems were less likely to report an overdose history (adjusted odds ratio 0.90, 95% confidence interval 0.81–0.99) and more likely to initiate opioid use for pain (adjusted odds ratio 2.52, 95% confidence interval 1.04–6.12) than those with primary heroin problems. Latent Class Analysis found that, while most of the POA group were similar to heroin users in demographics, health and injecting drug use, there was a small, distinct group of primary POA problem users that did not typically inject and who commonly initiated opioid use for pain and also experienced elevated physical and mental health disability. Discussion and Conclusions. While some differences existed, this study of Australian treatment seekers found many similar characteristics between those with primary problems with heroin and POA. Few non‐injecting POA were recruited in this sample. This finding contrasts with reports of a growing population of opioid‐dependent people with characteristics that are distinct from traditional opioid‐dependent populations, which may reflect the orientation of current treatment systems in Australia towards injection drug users.[Nielsen S, Bruno R, Lintzeris N, Fischer J, Carruthers S, Stoové M. Pharmaceutical opioid analgesic and heroin dependence: How do treatment‐seeking clients differ in Australia? Drug Alcohol Rev 2011;30:291–299]
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Non medical use of pharmaceutical opioids leading to injection heroin use and concomitant use of heroin and pharmaceutical opioids have been reported.
“Non medical use of pharmaceutical opioids leading to injection heroin use and concomitant use of heroin and pharmaceuticals opioids have been reported (Siegal et al., 1994; Lankenau et al., 2012; Nielsen et al., 2011; Wilkins et al., 2011).”
From National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. (2013) · cites this paper as Nielsen et al., 2011
Cites
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327 · see citing works
(2001) · Cited by 5,455 · see citing works
Self-report among injecting drug users: A review
Darke, S. (1998) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(98)00028-3 · Cited by 1,141 · see citing works
Major increases in opioid analgesic abuse in the United States: Concerns and strategies
Compton, W. M., & Volkow, N. D. (2005) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2005.05.009 · Cited by 831 · see citing works
Darke, S., Hall, W., Wodak, A., Heather, N., & Ward, J. (1992) · British Journal of Addiction · doi:10.1111/j.1360-0443.1992.tb02719.x · Cited by 485 · see citing works
Gender and Other Factors Associated with the Nonmedical Use of Abusable Prescription Drugs
Simoni, J. M., Ritter, G. A., & Strickler, G. K. (2004) · Substance Use & Misuse · doi:10.1081/ja-120027764 · Cited by 249 · 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
Results from the 2005 National Survey on Drug Use and Health: National Findings
(2006) · PsycEXTRA Dataset · doi:10.1037/e538292006-001 · Cited by 202 · see citing works
The Use of Abusable Prescription Drugs: The Role of Gender
Simoni, J. M. (2000) · Journal of Women s Health & Gender-Based Medicine · doi:10.1089/152460900318470 · Cited by 198 · see citing works
Australian Drug Trends 2000: Findings of the Illicit Drug Reporting System (IDRS)
Topp, L., Darke, S. G., Bruno, R., FRY, C. L., Hargreaves, K., HUMENIUK, R. E., McAllister, R., O'Reilly, B., & Williams, P. R. (2001) · eCite Digital Repository (University of Tasmania) · Cited by 193 · see citing works
Self-citationPrescription 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
Report of the International Narcotics Control Board for 2023
International Narcotics Control Board (2024) · Report of the International Narcotics Control Board for.../Report of the International Narcotics Control Board for ... · doi:10.18356/9789213587966 · Cited by 176 · 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
Frei, M. Y., Nielsen, S., Dobbin, M., & Tobin, C. (2010) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03911.x · Cited by 141 · see citing works
Self-citationExamination of opioid prescribing in Australia from 1992 to 2007
Leong, M., Murnion, B. P., & Haber, P. (2009) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2009.01982.x · Cited by 121 · see citing works
Changing patterns in opioid addiction: characterizing users of oxycodone and other opioids.
Sproule, B. A., Brands, B., Li, S., & Catz-Biro, L. (2009) · PubMed Central · Cited by 106 · see citing works
Australian Drug Trends 1999. Findings from the Illicit Drug Reporting System (IDRS)
Bruno, R., & McLean (2000) · Cited by 96 · see citing works
Self-citationCharacterizing the emerging population of prescription opioid abusers.
Sigmon, S. (2006) · American Journal on Addictions · doi:10.1080/10550490600625624 · Cited by 93 · see citing works
Darke, S. G., Ross, J. E., Teesson, M., & Lynskey, M. T. (2003) · Addiction · doi:10.1046/j.1360-0443.2003.00430.x · Cited by 87 · see citing works
Australian Drug Trends 2007: Findings from the Illicit Drug Reporting System (IDRS)
Black, E., Roxburgh, A., Degenhardt, L. J., Bruno, R., Campbell, G., de Graaff, B., Fetherston, J., Kinner, S. A., Moon, C., Quinn, B., et al. (2008) · eCite Digital Repository (University of Tasmania) · Cited by 73 · see citing works
Self-citationSilva, K. D., Jefferson, A. A., Pegrum, K., & Smith, L. (2011) · eCite Digital Repository (University of Tasmania) · Cited by 55 · see citing works
Treatment needs and experiences of Australian women with alcohol and other drug problems
Swift, W., & Copeland, J. (1996) · Drug and Alcohol Dependence · doi:10.1016/0376-8716(95)01209-5 · Cited by 48 · see citing works
SUBSTITUTION THERAPY FOR HEROIN ADDICTION
Bell, J. R., Dru, A., Fischer, B., Levit, S., & Sarfraz, M. A. (2002) · Substance Use & Misuse · doi:10.1081/ja-120004176 · Cited by 40 · see citing works
Finch, J. W., Kamien, J. B., & Amass, L. (2007) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e31809b5df2 · Cited by 39 · see citing works
The monitoring of drug trends in Australia
Shand, F., Topp, L., Darke, S. G., Makkai, T., & Griffiths, P. (2003) · Drug and Alcohol Review · doi:10.1080/0959523021000059848 · Cited by 39 · see citing works
Profiles of Club Drug Users in Treatment
Maxwell, J. C., & Spence, R. T. (2005) · Substance Use & Misuse · doi:10.1081/ja-200066968 · Cited by 31 · see citing works
O’Brien, S., Mattick, R. P., White, J. M., Breen, C. L., Kimber, J., Ritter, A., & Lintzeris, N. (2006) · Addictive Disorders & Their Treatment · doi:10.1097/01.adt.0000210078.99735.27 · Cited by 20 · see citing works
Self-citationInvestigation of Pharmaceutical Misuse Amongst Drug Treatment Clients
Nielsen, S., Bruno, R., CARRUTHERS, S. J., Fischer, G., Lintzeris, N., & Stoove, M. A. (2009) · eCite Digital Repository (University of Tasmania) · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Calcaterra, S., Glanz, J., & Binswanger, I. A. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.11.018 · Cited by 330 · see citing works
Prescription of opioid analgesics and related harms in Australia
Roxburgh, A., Bruno, R., Larance, B., & Burns, L. (2011) · The Medical Journal of Australia · doi:10.5694/mja10.11450 · Cited by 175 · see citing works
Self-citationFrank, D., Mateu‐Gelabert, P., Guarino, H., Bennett, A. S., Wendel, T., Jessell, L., & Teper, A. (2014) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2014.07.013 · Cited by 130 · see citing works
Prescription drug abuse: from epidemiology to public policy
McHugh, R. K., Nielsen, S., & Weiss, R. D. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.08.004 · Cited by 123 · see citing works
Self-citationStigma and Social Support in Pharmaceutical Opioid Treatment Populations: a Scoping Review
Cooper, S., & Nielsen, S. (2016) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-016-9719-6 · Cited by 63 · see citing works
Self-citationLatent patterns of polysubstance use among people who use opioids: A systematic review
Karamouzian, M., Pilarinos, A., Hayashi, K., Buxton, J. A., & Kerr, T. H. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2022.103584 · Cited by 47 · see citing works
Haber, P., Elsayed, M., Espinoza, D., Lintzeris, N., Veillard, A.-S., & Hallinan, R. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.09.024 · Cited by 37 · see citing works
Self-citationDeane, F. P., Kelly, P. J., Crowe, T. P., Coulson, J. C., & Lyons, G. C. B. (2013) · Journal of Addictive Diseases · doi:10.1080/10550887.2013.795470 · Cited by 35 · see citing works
Ambekar, A., Rao, R., Mishra, A. K., & Agrawal, A. C. (2014) · Drug and Alcohol Review · doi:10.1111/dar.12208 · Cited by 34 · see citing works
Roxburgh, A., Hall, W., Gisev, N., & Degenhardt, L. J. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.06.035 · Cited by 32 · see citing works
Hallinan, R., Elsayed, M., Espinoza, D., Veillard, A.-S., Morley, K. C., Lintzeris, N., & Haber, P. (2019) · Substance Use & Misuse · doi:10.1080/10826084.2018.1552298 · Cited by 28 · see citing works
Self-citationTwelve-year trend in treatment seeking for buprenorphine abuse in Finland
Tervonen, H. E., Kauhanen, J., Voutilainen, S., Föhr, J., Paasolainen, M., Tiihonen, J., Laitinen, K. S. M., Onyeka, I. N., & Bell, J. S. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.07.002 · Cited by 28 · see citing works
Pharmaceutical drug misuse in Australia
Dobbin, M. (2014) · Australian Prescriber · doi:10.18773/austprescr.2014.033 · Cited by 22 · see citing works
Quinn, B., Stoove, M. A., & Dietze, P. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.02.003 · Cited by 21 · see citing works
Nambiar, D., Agius, P. A., Stoove, M. A., Hickman, M., & Dietze, P. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.06.037 · Cited by 16 · see citing works
An Observational Study of Treatment Seeking Users of Natural Opiates from India
Parmar, A., Patil, V., Sarkar, S., & Rao, R. (2017) · Substance Use & Misuse · doi:10.1080/10826084.2017.1400564 · Cited by 16 · see citing works
A typology of prescription drug misuse: A latent class approach to differences and harms
Kelly, B. C., Rendina, H. J., Vuolo, M., Wells, B. E., & Parsons, J. T. (2014) · Drug and Alcohol Review · doi:10.1111/dar.12192 · Cited by 14 · see citing works
Hall, N. Y., Le, L. K., Majmudar, I. K., Teesson, M., & Mihalopoulos, C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0258620 · Cited by 12 · see citing works
Pharmaceutical drugs: The delicate balance between reducing pain and reducing harm
Nielsen, S., & Bruno, R. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2011.00326.x · Cited by 10 · see citing works
Self-citationAlvin, M., Picco, L., Wood, P., Mnatzaganian, G., & Nielsen, S. (2020) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-020-01152-8 · Cited by 9 · see citing works
Self-citationNielsen, S., Lintzeris, N., Murnion, B. P., Degenhardt, L. J., Bruno, R., Haber, P., Johnson, J. S., Hardy, M., Ling, S., Sadler, C., et al. (2018) · Drug and Alcohol Review · doi:10.1111/dar.12859 · Cited by 8 · see citing works
Self-citationTriage in Opioid Replacement Therapy: What's the Wait?
Harlow, W., Happell, B., Browne, G., Choudhury, J., & Pinchin, D. (2012) · Substance Use & Misuse · doi:10.3109/10826084.2012.736050 · Cited by 8 · see citing works
Tervonen, H. E., Ilomäki, J., Kauhanen, J., Tacke, U., Föhr, J., Tiihonen, J., & Bell, J. S. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.01.004 · Cited by 6 · see citing works
Bastien, G., Abboud, A., McAnulty, C., Elkrief, L., Ledjiar, O., Socias, M. E., Foll, B. L., Bahji, A., Brissette, S., Marsan, S., et al. (2024) · Journal of Dual Diagnosis · doi:10.1080/15504263.2024.2329267 · Cited by 5 · see citing works
Peacock, A., Degenhardt, L. J., Larance, B., Cama, E. J., Lintzeris, N., Ali, R. L., & Bruno, R. (2015) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3883 · Cited by 5 · see citing works
Self-citationHoryniak, D., Agius, P. A., Degenhardt, L. J., Reddel, S., Higgs, P., Aitken, C. K., Stoove, M. A., & Dietze, P. (2015) · Substance Use & Misuse · doi:10.3109/10826084.2015.1027928 · Cited by 4 · see citing works
Sarkar, S., Singh, R., Sharma, A., Pandit, M. A., Gupta, R., Singhal, D., Jain, R., & Balhara, Y. P. S. (2021) · Cureus · doi:10.7759/cureus.19310 · Cited by 4 · see citing works
Problematic Opioid Use: A Scoping Literature Review of Profiles
Archambault, L., Bertrand, K., & Perreault, M. (2022) · Substance Abuse Research and Treatment · doi:10.1177/11782218221103581 · Cited by 4 · see citing works
Siefried, K. J., Bascombe, F., Clifford, B., Liu, Z., Middleton, P., KAY‐LAMBKIN, F. J., Freestone, J., Herman, D., Millard, M., Steele, M., et al. (2024) · JMIR mhealth and uhealth · doi:10.2196/55663 · Cited by 3 · see citing works
Archambault, L., Bertrand, K., Jutras‐Aswad, D., Monson, E., Touré, E. H., & Perreault, M. (2023) · Drug and Alcohol Review · doi:10.1111/dar.13634 · Cited by 3 · see citing works
Classifying opioid use disorder based on diagnostic criteria items using cluster analysis
Birla, S., Patel, V., Gupta, D. S., Gupta, R., Balhara, Y. P. S., & Sarkar, S. (2025) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_430_24 · Cited by 1 · see citing works
Non‐Medical Use of Prescription Drugs among Clients Admitted to an Acute Psychiatric Unit
Chan, T. W., Alderman, C. P., Bell, J. S., & Ilomäki, J. (2013) · Journal of Pharmacy Practice and Research · doi:10.1002/j.2055-2335.2013.tb00272.x · Cited by 1 · see citing works
Prescription Opioid Analgesic Drug Misuse: What Can We Learn from Doctor-Shopping Behaviour
Loveday, B. (2017) · Queensland University of Technology · doi:10.5204/thesis.eprints.108061 · Cited by 1 · see citing works
Polysubstance Opioid Use in a Justice-Involved Population
Bunting, A. M. (2019) · UKnowledge (University of Kentucky) · doi:10.13023/etd.2019.171
Polysubstance use patterns among people with opioid use disorder in Vancouver, Canada
Karamouzian, M. (2021) · cIRcle (University of British Columbia) · doi:10.14288/1.0402658
- Authors
- NIELSEN, S., BRUNO, R., LINTZERIS, N., FISCHER, J., CARRUTHERS, S., & STOOVÉ, M.
- Affiliations
- Eastern Health (AU)
- University of Tasmania (AU)
- The University of Sydney (AU)
- Queensland Health (AU)
- Curtin University (AU)
- Corresponding author
- NIELSEN, SUZANNE
- Venue
- Drug and Alcohol Review
- Publisher
- Wiley
- Published
- 2011-05
- Volume
- 30
- Issue
- 3
- Pages
- 291-299
- ISSN
- 0959-5236 (ISSN-L)
- 1465-3362
- OpenAlex
- W1588202868
- Cited by
- 35
- References
- 29
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 4 · 2012: 2
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Drug and Alcohol Review (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Department of Health, State Government of Victoria
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- heroin addiction, opioid use disorder, intravenous drug use, opioid overdose, drug treatment services, Australia
- MeSH terms
- Adolescent, Adult, Analgesics, Opioid, Australia, Heroin, Female, Heroin Dependence, Humans, Male, Middle Aged, Opioid-Related Disorders, Patient Acceptance of Health Care, Young Adult, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
