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

Details

• Alternative Title:
  J Addict Med
• Personal Author:
  Hartung, Daniel ; Geddes, Jonah ; Johnston, Kirbee A. ; Leichtling, Gillian ; Hallvik, Sara ; Hildebran, Christi ; Korthuis, P. Todd
• 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.
  
  
• Subjects:
  Analgesics, Opioid Article Case-Control Studies Heroin Humans Opioid-Related Disorders Opioid Use Disorder Prescription Opioids Prescriptions Self Report United States

  More +
• Source:
  J Addict Med. 15(2):130-133
• Pubmed ID:
  32732683
• Pubmed Central ID:
  PMC7855393
• Document Type:
  Journal Article
• Funding:
  U01 CE002786/CE/NCIPC CDC HHSUnited States/
• Volume:
  15
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ce95a6c81e4d6c2b9622117ce76b1577e94065d31c0c000e22f7dedcfa09d9c7
• Download URL:
  https://stacks.cdc.gov/view/cdc/102161/cdc_102161_DS1.pdf
• File Type:
  [PDF - 51.71 KB ]