title: Perceived risk of heroin use among nonmedical prescription opioid users.
abstract: The prevalence of heroin use among nonmedical prescription opioid (NMPO) users has increased in recent years. Identifying characteristics associated with heroin use in this population can help inform efforts to prevent heroin initiation and maintenance. The aim of this study was to evaluate differences in perceived risk of heroin among NMPO users with and without histories of heroin use, and to examine temporal trends in perceived risk of heroin among this population.
  
  
  
  Data are from the 2002-2013 National Survey on Drug Use and Health, and included all past-year NMPO users (N=49,045). Participants reported perceived risk of trying heroin once or twice and regular heroin use. Responses were coded dichotomously (great risk vs. other risk) and logistic regression analyses were used to evaluate the association between lifetime heroin use and perceived risk of heroin, and to determine temporal changes in perceived risk.
  
  
  
  Results indicated a significant association between lifetime heroin use and lower likelihood of reporting great risk of trying heroin (OR=0.38, 95% CI: 0.33, 0.44, p<0.001), and of regular use of heroin (OR=0.39, 95% CI: 0.32, 0.48, p<0.001). There was a significant, yet modest, trend toward decreasing perception of great risk from 2002 to 2013.
  
  
  
  Findings from this analysis of nationally representative data indicate that NMPO users with a history of heroin use perceive heroin to be less risky than those without heroin use. Perception of risk has decreased from 2002 to 2013 in this population, consistent with increasing rates of heroin initiation.
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States. Electronic address: vvotaw@mclean.harvard.edu.
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Votaw
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Partners HealthCare, 800 Boylston Street, Boston, MA 02199, United States.
authors.forename: Justine
authors.initials: J
authors.lastname: Wittenauer
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
authors.forename: Hilary S
authors.initials: HS
authors.lastname: Connery
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
authors.forename: R Kathryn
authors.initials: RK
authors.lastname: McHugh
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006556:Heroin Dependence / Q000523:psychology*; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000523:psychology*; D063487:Prescription Drug Misuse / Q000523:psychology*; D012306:Risk; D014481:United States; D055815:Young Adult
keywords: Heroin; National Survey on Drug Use and Health; Nonmedical prescription opioid use; Opioid; Perceived risk