title: Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers - United States, 2002-2004 and 2008-2010.
abstract: BACKGROUND
  Heroin use and overdose deaths have increased in recent years. Emerging information suggests this is the result of increases in nonmedical use of opioid pain relievers and nonmedical users transitioning to heroin use. Understanding this relationship is critically important for the development of public health interventions.
  
  
  METHODS
  Combined data from the 2002-2004 National Surveys on Drug Use and Health were compared to the 2008-2010 surveys to examine patterns of heroin use and risk behaviors among past year nonmedical users of opioid pain relievers.
  
  
  RESULTS
  Between 2002-2004 and 2008-2010, past year heroin use increased among people reporting past year nonmedical use (PYNMU) of opioid pain relievers (p<0.01), but not among those reporting no PYNMU. Frequent nonmedical users - people reporting 100-365 days of PYNMU - had the highest rate of past year heroin use and were at increased risk for ever injecting heroin (aOR 4.3, 95% CI 2.5-7.3) and past year heroin abuse or dependence (aOR 7.8, 95% CI 4.7-12.8) compared to infrequent nonmedical users (1-29 days of PYNMU). In 2008-2010, 82.6% of frequent nonmedical users who used heroin in the past year reported nonmedical use of opioid pain relievers prior to heroin initiation compared to 64.1% in 2002-2004.
  
  
  CONCLUSIONS
  Heroin use among nonmedical users of opioid pain relievers increased between 2002-2004 and 2008-2010, with most reporting nonmedical use of opioid pain relievers before initiating heroin. Interventions to prevent nonmedical use of these drugs are needed and should focus on high-risk groups such as frequent nonmedical users of opioids.
authors: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States. cjones@cdc.gov
authors: Christopher M
authors: CM
authors: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000701:Analgesics, Opioid; D002648:Child; D005260:Female; D006306:Health Surveys; D006556:Heroin Dependence / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D064226:Prescription Drug Diversion / Q000706:statistics & numerical data*; D063487:Prescription Drug Misuse / Q000523:psychology*; D012306:Risk; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Heroin; NSDUM; National Survey on Drug Use and Health; Prescription opioid use; Prescription opioids