Hilary L Surratt1, Steven P Kurtz2, Mance Buttram3, Maria A Levi-Minzi4, Maria E Pagano5, Theodore J Cicero6. 1. Center for Health Services Research, Department of Internal Medicine, University of Kentucky,740 South Limestone Avenue, Lexington, KY, 40536, USA; Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA. Electronic address: hilary.surratt@uky.edu. 2. Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA. Electronic address: steven.kurtz@nova.edu. 3. Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA. Electronic address: mance.buttram@nova.edu. 4. Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA. Electronic address: maria.leviminzi@nova.edu. 5. Department of Psychiatry, Division of Child Psychiatry, Case Western Reserve University, 10524 Euclid Avenue #1155A, Cleveland, OH, 44106 USA. Electronic address: maria.pagano@UHhospitals.org. 6. Department of Psychiatry,Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, MO, 63110, USA. Electronic address: cicerot@psychiatry.wustl.edu.
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.
RCT Entities:
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.
Authors: Kelly Quinn; Bartley C Frueh; Joy Scheidell; Daniel Schatz; Faith Scanlon; Maria R Khan Journal: Drug Alcohol Depend Date: 2019-02-14 Impact factor: 4.492
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