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Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation. | LitMetric

Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation.

J Addict Med

College of Pharmacy, Oregon State University / Oregon Health & Science University, Portland, OR (DH, JG, KAJ); Comagine Health, Portland, OR (GL, SH, CH); Division of General Internal Medicine and Geriatrics, School of Medicine, Oregon Health & Science University, Portland, OR (PTK).

Published: April 2021

AI Article Synopsis

  • The study aimed to explore the link between self-reported heroin use and patterns of prescription opioid usage by analyzing data from Oregon between 2015 and 2017.
  • Nearly half of the individuals who reported starting heroin had filled at least one opioid prescription in the year prior, with a notable tendency to get prescriptions from multiple healthcare providers and pharmacies compared to a control group.
  • Despite the common occurrence of prescription opioid use prior to heroin initiation, long-term opioid therapy was rare, and the study did not find a clear link between stopping opioids and starting heroin, suggesting more research is needed on the implications of opioid prescription practices.

Article Abstract

Objectives: To determine the association between self-reported heroin initiation and patterns of prescription opioid use.

Methods: Using linked Oregon Medicaid, prescription drug monitoring program, and Treatment Episodes Data Set data, we conducted a case-control study of individuals reporting heroin initiation between 2015 and 2017 during treatment intake. Prescription drug monitoring program data provided prescription opioid use patterns, including long-term prescription opioid therapy, in the year before self-reported heroin initiation. Four controls were matched to each case on aggregate prescription opioid use and demographics.

Results: About half (49%) of individuals who reported heroin initiation filled an opioid in the year before initiation. Individuals who initiated heroin (n = 306) were more likely to receive prescriptions from multiple prescribers (24% vs 18%, P = 0.007) and pharmacies (12% vs 5%, P < 0.001) compared with matched controls (n = 1224). Long-term opioid therapy (13% vs 14%, P = 0.74) was uncommon and did not differ between groups.

Conclusions: Although prescription opioid use commonly preceded self-reported heroin initiation, long-term opioid therapy was not common. Although this study did not find an association between opioid discontinuation and heroin initiation, sample size and follow-up limitations preclude definitive conclusions. Efforts to limit prescription opioids should continue to evaluate for unintended harms.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855393PMC
http://dx.doi.org/10.1097/ADM.0000000000000708DOI Listing

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