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. 2021 Apr 1;15(2):130-133.
doi: 10.1097/ADM.0000000000000708.

Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation

Daniel M Hartung  1 , Jonah Geddes, Kirbee A Johnston, Gillian Leichtling, Sara Hallvik, Christi Hildebran, P Todd Korthuis
Affiliations

Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation

Daniel M Hartung et al. J Addict Med. .

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.

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Conflict of interest statement

The authors have no conflicts of interests to disclose.

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