CAHSS Faculty Articles

Department

Department of Justice and Human Services

Publication Date

7-26-2017

Publication Title

Drug and Alcohol Dependence: An International Journal on Biomedical and Psychosocial Approaches

ISSN

1879-0046

Volume

179

Issue/No.

2017

First Page

131

Last Page

138

Abstract

Background Nonmedical prescription opioid use (NMPOU) is well documented among participants in the club scene, yet prior studies have not examined transition to heroin use. We prospectively examined heroin initiation among a sample of young adults with drug involvement associated with participation in the club scene, to understand factors that influence transition from NMPOU to heroin and to identify opportunities for intervention.

Methods Data were drawn from a randomized trial that enrolled 750 Miami-based club and prescription drug users through respondent driven sampling, and tested the efficacy of assessment interventions in reducing risk. Participants reported current substance use at baseline, 3, 6, and 12 month follow-ups. We examined predictors of heroin initiation among participants reporting NMPOU at baseline, with no lifetime history of heroin use (N = 323).

Results The mean age was 25.0 years; 67.5% met DSM-IV criteria for substance dependence. About 1 in 13 participants (7.7%) initiated heroin use at follow-up. In univariable comparisons, frequent LSD use, history of drug overdose, high frequency NMPOU, using oral tampering methods, and endorsing a primary medical source for prescription opioids were associated with greater likelihood of heroin initiation. LSD use, oral tampering, and primary medical source were significant predictors in a Cox regression model.

Conclusions Heroin initiation of 7.7% suggests a high level of vulnerability for transition among young adult NMPO users in the club scene. The importance of oral tampering methods in the trajectory of NMPOU may indicate a need to further examine the role of abuse deterrent formulations in prevention efforts.

ORCID ID

0000-0003-4027-7840, 0000-0002-5001-7391, 0000-0003-4406-8894, 0000-0002-4716-3398

ResearcherID

K-3072-2014, H-3010-2014

DOI

10.1016/j.drugalcdep.2017.06.034

Peer Reviewed

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