Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation. Issue 2 (March 2021)

• Record Type: Journal Article
• Authors: Hartung, Daniel M.; Geddes, Jonah; Johnston, Kirbee A.; Leichtling, Gillian; Hallvik, Sara; Hildebran, Christi; Korthuis, P. Todd
• Is Part Of: Journal of addiction medicine. Volume 15:Issue 2(2021)
• Publication Date: 2021-03
• Subjects: heroin -- opioid use disorder -- prescription opioids; Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86005
• DOI: 10.1097/ADM.0000000000000708
• Languages: English
• ISSNs: 1932-0620

Abstract

Abstract : 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, and Treatment Episodes Data Set data, we conducted a case-control study of individuals reporting heroin initiation between 2015 and 2017 during treatment intake. Prescription drug monitoring program data provided prescription opioid use patterns, including long-term prescription opioid therapy, in the year before 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 before 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 = 1224). 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.