title: How do prescription opioid users differ from users of heroin or other drugs in psychopathology: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
abstract: OBJECTIVE
  To study substance use and psychiatric disorders among prescription opioid users, heroin users, and non-opioid drug users in a national sample of adults.
  
  
  METHODS
  Analyses of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093).
  
  
  RESULTS
  Four groups were identified among 9140 illicit or non-prescribed drug users: heroin-other opioid users (1.0%; used heroin and other opioids), other opioid-only users (19.8%; used other opioids but never heroin), heroin-only users (0.5%; used heroin but never other opioids), and non-opioid drug users (78.7%; used drugs but never heroin or other opioids). After adjusting for variations in socioeconomic characteristics, history of substance abuse treatment, and familial substance abuse, heroin-other opioid users had greater odds of several substance use disorders (cocaine, hallucinogen, sedative, amphetamine, and tranquilizer) as compared with the other groups; heroin-only users had reduced odds of sedative and tranquilizer use disorders as compared with other opioid-only users. Non-opioid drug users had reduced odds of all substance use disorders and other mental disorders (mood, anxiety, pathological gambling, and personality) as compared with other opioid-only users. Past-year other opioid-only users also reported slightly lower scores on quality of life than past-year non-opioid drug users.
  
  
  CONCLUSIONS
  All opioid use groups had higher rates of substance use disorders than non-opioid drug users, and these rates were particularly elevated among heroin-other opioid users. Findings suggest the need to distinguish between these four groups in research and treatment as they may have different natural histories and treatment needs.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. litzy.wu@duke.edu
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.forename: George E
authors.initials: GE
authors.lastname: Woody
authors.forename: Chongming
authors.initials: C
authors.lastname: Yang
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006556:Heroin Dependence / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D013287:Illicit Drugs; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D011599:Psychopathology; D011788:Quality of Life / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D014481:United States; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D009294:Narcotics