Study: Most high school heroin users started with prescription opioids

Three-quarters of high school heroin users started with pills, which researchers said many teens may think are less addictive or dangerous because they are government approved and prescribed by doctors.

By Stephen Feller

NEW YORK, Dec. 3 (UPI) -- Non-medical use and abuse of prescription opioid painkillers has grown significantly in recent years, concurrent with a rise in heroin use.

A new study solidifies that link, as researchers at New York University found that three-quarters of high school heroin users took prescription opioids before trying the more addictive illicit drug.


Heroin has seen a revival of abuse over the last several years with overdose deaths nearly tripling since 2010, in addition to prescription opioid overdoses quadrupling since 1999. Both increases led the Centers for Disease Control and Prevention to mount a $20 million program to tackle the problem in the 16 states hit the hardest by both abuse epidemics.

Previous studies have shown teenagers increasingly using opioid drugs such as OxyContin, oxycodone, Percocet and other morphine-based drugs because they are easier to get. The problem has been prevalent in small towns, where teenagers find it easier to seek treatment at hospitals and walk away with the drugs, researchers have reported.


Although rural and small urban teens have been found to be more likely to favor prescription medications over street drugs, while teens in big cities start with drugs from doctors before switching to illicit drugs, researchers found in the new study.

"As frequency of lifetime opioid use increased, so too did the odds for reporting heroin use, with over three-quarters of heroin users reporting lifetime nonmedical opioid use," said Dr. Joseph J. Palamar, an associate professor at NYU Langone Medical Center, in a press release. "More frequent and more recent nonmedical opioid use was associated with increased odds for reporting heroin use."

Using data on 67,822 students collected as part of the Monitoring the Future study, researchers analyzed associations between frequency and recency of non-medical use of of opioids and heroin, as well as use among social and demographic groups.

Overall, 12.4 percent of students reported using medical opioids for non-medical reasons at some point in their lives and 1.2 percent said they'd used heroin. Of those who reported heroin use, 77.3 percent said they also had taken prescription opioids at some point.

Researchers also found recent medical-grade opioid use was a high risk factor for heroin use, as was frequency of use -- 23.2 percent of students who used the medications more than 40 times also said they had used heroin.


The researchers said black and Hispanic students were at lower risk for using either medical opioids or heroin, but both demographic groups were more likely to use heroin without first trying prescription medications.

"This suggests that it is primarily the white students who may be transitioning from pill use to heroin," said Dr. Pedro Mateu-Gelabert, a researcher at the Center for Drug Use and HIV Research at NYU.

"A teen may take an Oxy a couple of times and remain unscathed," Palamar said. "But a lot of teens don't realize these pills can be physically addicting. A lot of teens don't trust warnings about the harm prescription opioids can cause because they're taught that using any drug -- even marijuana, even once -- will ruin their life forever."

The study is published in the journal Drug and Alcohol Dependence.

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