title: Age differences in heroin and prescription opioid abuse among enrolees into opioid treatment programs.
abstract: BACKGROUND
  In the United States, among those entering opioid treatment programs (OTPs), prescription opioid (PO) abusers tend to be younger than heroin users. Admissions of older persons to OTPs have been increasing, and it is important to understand typical patterns of use among those older enrolees.
  
  
  METHODS
  To disentangle the effect of age on recent heroin and PO abuse 29,114 enrolees into 85 OTPs were surveyed across 34 states from 2005-2009. OTPs where PO use was prevalent were oversampled.
  
  
  RESULTS
  Mean age was 34; 28% used heroin only. Younger enrolees had increased odds of using POs relative to using heroin only but mixed model analysis showed that much of the total variability in type of use was attributed to variation in age between OTPs rather than within OTPs.
  
  
  CONCLUSIONS
  Organizational and cultural phenomena (e.g., OTP characteristics) must be examined to better understand the context of individual characteristics (e.g., age). If nesting of enrolees within OTPs is ignored, then associations that primarily operate at the OTP level may be misinterpreted as exclusively dependent on individuals.
authors.affiliation: New York University College of Nursing, 726 Broadway, New York City, New York, USA. chuck.cleland@nyu.edu
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
authors.forename: Chunki
authors.initials: C
authors.lastname: Fong
authors.forename: Carleen
authors.initials: C
authors.lastname: Maxwell
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D055553:Prescription Drugs / Q000008:administration & dosage; D012111:Residence Characteristics; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D055553:Prescription Drugs