Abstract
Background—Nonmedical prescription opioid use (NMPOU) is well documented among participants in the club scene, yet prior studies have not examined transition to heroin use. We prospectively examined heroin initiation among a sample of young adults with drug involvement associated with participation in the club scene, to understand factors that influence transition from NMPOU to heroin and to identify opportunities for intervention.
Methods—Data were drawn from a randomized trial that enrolled 750 Miami-based club and prescription drug users through respondent driven sampling, and tested the efficacy of assessment interventions in reducing risk. Participants reported current substance use at baseline, 3, 6, and 12 month follow-ups. We examined predictors of heroin initiation among participants reporting NMPOU at baseline, with no lifetime history of heroin use (N=323).
Results—The mean age was 25.0 years; 67.5% met DSM-IV criteria for substance dependence. About 1 in 13 participants (7.7%) initiated heroin use at follow-up. In univariable comparisons, frequent LSD use, history of drug overdose, high frequency NMPOU, using oral tampering methods, and endorsing a primary medical source for prescription opioids were associated with greater likelihood of heroin initiation. LSD use, oral tampering, and primary medical source were significant predictors in a Cox regression model.
Conclusions—Heroin initiation of 7.7% suggests a high level of vulnerability for transition among young adult NMPO users in the club scene. The importance of oral tampering methods in the trajectory of NMPOU may indicate a need to further examine the role of abuse deterrent formulations in prevention efforts.
Document Type
Article
Publication Date
10-1-2017
Digital Object Identifier (DOI)
https://doi.org/10.1016/j.drugalcdep.2017.06.034
Funding Information
This research was supported by Award Number R01DA019048 from the National Institute on Drug Abuse.
Repository Citation
Surratt, Hilary L.; Kurtz, Steven P.; Buttram, Mance; Levi-Minzi, Maria A.; Pagano, Maria E.; and Cicero, Theodore J., "Heroin Use Onset Among Nonmedical Prescription Opioid Users in the Club Scene" (2017). Center for Health Services Research Faculty Publications. 4.
https://uknowledge.uky.edu/chsr_facpub/4
Included in
Behavior and Behavior Mechanisms Commons, Health Services Research Commons, Pharmacy Administration, Policy and Regulation Commons, Substance Abuse and Addiction Commons
Notes/Citation Information
Published in Drug and Alcohol Dependence, v. 179, p. 131-138.
© 2017 Elsevier B.V. All rights reserved.
This manuscript version is made available under the CC‐BY‐NC‐ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/.
The document available for download is the author's post-peer-review final draft of the article.