Patterns of prescription opioid use prior to self-reported heroin initiation
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Patterns of prescription opioid use prior to self-reported heroin initiation

  • Published Date:

    Apr 01 2021

  • Source:
    J Addict Med. 15(2):130-133
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Public Access Version Available on: April 01, 2022, 12:00 AM information icon
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  • Alternative Title:
    J Addict Med
  • Description:
    Objectives: To determine the association between self-reported heroin initiation and patterns of prescription opioid use. Methods: Using linked Oregon Medicaid, prescription drug monitoring program (PDMP), and Treatment Episodes Data Set data, we conducted a case-control study of individuals reporting heroin initiation between 2015 and 2017 during treatment intake. PDMP data provided prescription opioid use patterns, including long-term prescription opioid therapy, in the year prior to self-reported heroin initiation. Four controls were matched to each case on aggregate prescription opioid use and demographics. Results: About half (49%) of individuals who reported heroin initiation filled an opioid in the year prior to initiation. Individuals who initiated heroin (n=306) were more likely to receive prescriptions from multiple prescribers (24% vs 18%, p=0.007) and pharmacies (12% vs 5%, p<0.001) compared with matched controls (n=1,224). Long-term opioid therapy (13% vs 14%, p=0.74) was uncommon and did not differ between groups. Conclusions: Although prescription opioid use commonly preceded self-reported heroin initiation, long-term opioid therapy was not common. Although this study did not find an association between opioid discontinuation and heroin initiation, sample size and follow-up limitations preclude definitive conclusions. Efforts to limit prescription opioids should continue to evaluate for unintended harms.
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