title: Comparing characteristics of prescription painkiller misusers and heroin users in the United States.
abstract: BACKGROUND
  Prescription painkiller misuse (PPM) is a major U.S. public health concern. However, as prescribing practices have tightened and prescription painkillers have become less accessible, many users have turned to heroin as a substitute. This trend suggests the face of heroin users has likely changed over the past several years. Understanding the demographic, socioeconomic, psychosocial, and substance use characteristics of different groups of opiate users is important for properly tailoring interventions.
  
  
  METHODS
  This study used data from the 2010-2013 National Survey on Drug Use and Health to examine differences in characteristics of U.S. adults in three mutually exclusive categories of past-year opiate use: heroin-only (H-O, N=179), prescription painkiller-only (PP-O, N=9,516), and heroin and prescription painkiller (H-PP, N=506).
  
  
  RESULTS
  Socioeconomic disadvantage, older age, disconnection from social institutions, criminal justice involvement, and easy access to heroin were associated with greater odds of being in the H-O group. HH-P users were more likely to be young white males with poor physical and mental health who also misuse other prescription medications and began such misuse as adolescents. PP-O users were the most economically stable, most connected to social institutions, least likely to have criminal justice involvement, and had the least access to heroin.
  
  
  CONCLUSIONS
  Results suggest the socio-demographic characteristics of heroin users versus PP misusers vary widely, and the conditions leading to heroin use versus PPM versus both may be different. Ultimately, a one-size-fits-all approach to opiate prevention and treatment is likely to fail. Interventions must account for the unique needs of different user groups.
authors.affiliation: Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, United States. Electronic address: rigg@usf.edu.
authors.forename: Khary K
authors.initials: KK
authors.lastname: Rigg
authors.affiliation: Department of Agricultural Economics, Sociology, and Education, Population Research Institute, The Pennsylvania State University.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Monnat
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Heroin; Opiates; Prescription painkiller misuse; Prevention; Treatment