People ages 12 to 49 who had used prescription pain relievers nonmedically were 19 times more likely than others to have initiated heroin use within the past 12 months, according to a government report.
Of those studied who had used prescription pain relievers nonmedically, 0.39% initiated heroin use, compared with 0.02% of those who had not.
And 79.5% of recent initiators of heroin use had previously used prescription pain relievers nonmedically, reported the Substance Abuse and Mental Health Services Administration.
In all, the vast majority of people using prescription pain relievers nonmedically did not start using heroin: Only 3.6% of the people who initiated the nonmedical use of pain relievers went on to use heroin within five years.
“Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” Peter Delany, PhD, LCSW-C, director of SAMHSAs Center for Behavioral Health Statistics and Quality, said in a news release. “This report shows that it can also greatly increase an individuals risk of turning to heroin use, thus adding a new dimension of potential harm.”
The reports examination of the association between the nonmedical use of prescription pain relievers and the initiation of heroin use is part of SAMHSAs efforts to identify some of the factors that may explain the rise in the rates of heroin use, dependence and initiation over the past few years.
The number of people reporting they have used heroin in the past 12 months rose from 373,000 people in 2007 to 620,000 people in 2011. Similarly, the number of people dependent on heroin in the past 12 months climbed from 179,000 people in 2007 to 369,000 people in 2011, and the number of people using heroin for the first time in the past 12 months increased from 106.000 to 178,000.
The report also found significant shifts between 2008 and 2011 in heroin initiation levels and patterns. For example, although overall heroin initiation rose among all 12- to 49-year-olds, these increases were seen only among adults ages 18 to 25 and 26 to 49, with no change in the rate among youths ages 12 to 17. Heroin initiation among people with annual incomes less than $20,000 and $20,000 to $49,999 also increased during this time period.
Past-year heroin initiation rates went up sharply in all regions of the nation during this period except the South, where the rates stayed the lowest in the country. Heroin initiation rates also were lower among blacks than among other racial and ethnic groups.
SAMHSA offers a number of web-based and print materials to educate patients, the public and providers about prescription drug abuse, including the “Not Worth the Risk, Even If Its Legal” campaign and the “Prescribers Clinical Support System for Opioid Therapies,” which provides support, training and mentoring services to a variety of healthcare providers on the safe and appropriate prescribing of opioids.
The report, “Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States,” is based on data from SAMHSAs National Survey on Drug Use and Health, covering the period of 2002 to 2011. NSDUH is a national survey of more than 67,500 people ages 12 and older.