Nonmedical Prescription Opioid Use in Childhood and Early Adolescence Predicts Transitions to Heroin Use in Young Adulthood: A National Study - PubMed (original) (raw)

Nonmedical Prescription Opioid Use in Childhood and Early Adolescence Predicts Transitions to Heroin Use in Young Adulthood: A National Study

Magdalena Cerdá et al. J Pediatr. 2015 Sep.

Abstract

Objectives: To examine the relationship between nonmedical use of prescription opioids and heroin initiation from childhood to young adulthood, and to test whether certain ages, racial/ethnic, and income groups were at higher risk for this transition.

Study design: Among a nationally representative sample of US adolescents assessed in the 2004-2011 National Surveys on Drug Use and Health cross-sectional surveys (n = 223,534 respondents aged 12-21 years), discrete-time hazard models were used to estimate the age-specific hazards of heroin initiation associated with prior history of nonmedical use of prescription opioids. Interactions were estimated between prior history of nonmedical use of prescription opioids and age of nonmedical use of prescription opioid initiation, race/ethnicity, and income.

Results: A prior history of nonmedical use of prescription opioids was strongly associated with heroin initiation (hazard ratio 13.12, 95% CI 10.73, 16.04). Those initiating nonmedical use of prescription opioids at ages 10-12 years had the highest risk of transitioning to heroin use; the association did not vary by race/ethnicity or income group.

Conclusions: Prior use of nonmedical use of prescription opioids is a strong predictor of heroin use onset in adolescence and young adulthood, regardless of the user's race/ethnicity or income group. Primary prevention of nonmedical use of prescription opioids in late childhood may prevent the onset of more severe types of drug use such as heroin at later ages. Moreover, because the peak period of heroin initiation occurs at ages 17-18 years, secondary efforts to prevent heroin use may be most effective if they focus on young adolescents who already initiated nonmedical use of prescription opioids.

Copyright © 2015. Published by Elsevier Inc.

PubMed Disclaimer

Conflict of interest statement

The other authors declare no conflicts of interest.

Figures

Figure 1

Figure 1

Fitted probability of A, heroin initiation and B, survival by prior nonmedical prescription opioid use among adolescents and young adults, NSDUH (2004-2001).

Figure 2

Figure 2

Fitted HRs of heroin initiation associated with prior nonmedical prescription opioid use, by age of nonmedical prescription opioid use initiation (NSDUH, 2004-2011).

None

Comment in

Similar articles

Cited by

References

    1. SAMHSA. NSDUH Series H-48, HHS Publication No (SMA) 14–4863. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings.
    1. SAMHSA. NSDUH Series H-44, HHS Publication No (SMA) 12–4713. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2012. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings.
    1. Lankenau SE, Schrager SM, Silva K, Kecojevic A, Bloom JJ, Wong C, et al. Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York. J Public Health Res. 2012;1:22–30. - PMC - PubMed
    1. Mars SG, Bourgois P, Karandinos G, Montero F, Ciccarone D. “Every ‘never’ I ever said came true”: transitions from opioid pills to heroin injecting. Int J Drug Policy. 2014;25:257–66. - PMC - PubMed
    1. Lankenau SE, Teti M, Silva K, Bloom JJ, Harocopos A, Treese M. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy. 2012;23:37–44. - PMC - PubMed

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources