Tuesday, August 5, 2014

Recent Heroin Users Often First Used Prescription Opioids, New Study Finds

Heroin use has long been thought of as primarily an inner-city problem of young men, according to the authors of a new study of the problem, but new data based on treatment use show that it now also extends to older men and women living outside of large urban areas and who came to the drug after first using prescription opioids. This is the key finding from a study published in JAMA Psychiatry by lead researcher Theodore Cicero, Ph.D., of the Department of Psychiatry at Washington University in St. Louis and colleagues.

Some 2,800 individuals with a DSM-IV diagnosis of heroin use/dependence and who had entered substance abuse treatment programs across the country were surveyed about their past drug use and why heroin had become their drug of choice. Respondents who began using heroin in the 1960s were mostly young men in urban areas whose first opioid of abuse was heroin. But more recent users were older men and women living in less-urban areas and who were introduced to opioids through prescription drugs. Both whites and nonwhites were equally represented in those initiating use prior to the 1980s, but nearly 90 percent of respondents who began use in the last decade were white. Those who transitioned from prescription opioids to heroin often did so, they said, because it was more readily accessible and much less expensive than prescription opioids.

The transition of many users from prescription opioids to heroin may have been driven partially by the introduction in 2010 of abuse-resistant formulations of prescription opioids, compelling some addicts to seek an alternative that was easier to obtain and to use, the researchers said. There is also some positive news on the problem of opioid abuse, as the Substance Abuse and Mental Health Services Administration (SAMHSA) pointed out in a recent report. For example, there has been a decline in prescription opioid abuse among both youth and young adults from 2007 to 2011. Another was that from 2006 to 2010, the number of people receiving buprenorphine treatment for heroin addiction jumped 400 percent. To read more about the SAMHSA findings, see the Psychiatric News article, "Recent Mental Health Trends Provide Reasons for Optimism."

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