title: Racial/ethnic differences in trends in heroin use and heroin-related risk behaviors among nonmedical prescription opioid users.
abstract: BACKGROUND
  This study examines changing patterns of past-year heroin use and heroin-related risk behaviors among individuals with nonmedical use of prescription opioids (NMUPO) by racial/ethnic groups in the United States.
  
  
  METHODS
  We used data from the National Survey on Drug Use and Health (NSDUH) from 2002 to 2005 and 2008 to 2011, resulting in a total sample of N = 448,597.
  
  
  RESULTS
  Past-year heroin use increased among individuals with NMUPO and increases varied by frequency of past year NMUPO and race/ethnicity. Those with NMUPO in the 2008-2011 period had almost twice the odds of heroin use as those with NMUPO in the 2002-2005 period (OR = 1.89, 95%CI: 1.50, 2.39), with higher increases in non-Hispanic (NH) Whites and Hispanics. In 2008-2011, the risk of past year heroin use, ever injecting heroin, past-year heroin abuse or dependence, and the perception of availability of heroin increased as the frequency of NMUPO increased across respondents of all race/ethnicities.
  
  
  CONCLUSIONS
  Individuals with NMUPO, particularly non-Hispanic Whites, are at high risk of heroin use and heroin-related risk behaviors. These results suggest that frequent nonmedical users of prescription opioids, regardless of race/ethnicity, should be the focus of novel public health efforts to prevent and mitigate the harms of heroin use.
authors: Department of Epidemiology, Columbia University, New York, NY, USA. Electronic address: ssm2183@columbia.edu.
authors: Silvia S
authors: SS
authors: Martins
authors: Department of Epidemiology, Columbia University, New York, NY, USA.
authors: Julian
authors: J
authors: Santaella-Tenorio
authors: Department of Epidemiology, Brown University, Providence, RI, USA.
authors: Brandon D L
authors: BD
authors: Marshall
authors: Department of Epidemiology, Columbia University, New York, NY, USA.
authors: Adriana
authors: A
authors: Maldonado
authors: Department of Epidemiology, Columbia University, New York, NY, USA.
authors: Magdalena
authors: M
authors: Cerdá
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid; D044383:Black People; D002648:Child; D005006:Ethnicity; D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D006630:Hispanic or Latino; D006801:Humans; D007198:Indians, North American; D008297:Male; D063487:Prescription Drug Misuse / Q000523:psychology* / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult; D001741:Black or African American
chemical_list: D000701:Analgesics, Opioid
keywords: Heroin; Heroin-risk behaviors; National Survey on Drug Use and Health; Nonmedical use of prescription opioids; Race/ethnicity