Abstract
AIMS: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care.
DESIGN: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use.
SETTING: Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC.
PARTICIPANTS: A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012.
MEASUREMENTS: The primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use.
FINDINGS: Using a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR)�=�5.43, 95% confidence interval (CI)�=�4.01, 7.35].
CONCLUSIONS: New-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2021-2031 |
| Number of pages | 11 |
| Journal | Addiction (Abingdon, England) |
| Volume | 111 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2016 |
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Keywords
- Heroin
- longitudinal study
- non-medical prescription drug use
- opioid-related disorders
- polysubstance use
- veterans
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health
Cite this
Non-medical use of prescription opioids is associated with heroin initiation among US veterans : a prospective cohort study. / Banerjee, Geetanjoli; Edelman, E. Jennifer; Barry, Declan T.; Becker, William C.; Cerda, Magdalena; Crystal, Stephen; Gaither, Julie R.; Gordon, Adam J.; Gordon, Kirsha S.; Kerns, Robert D.; Martins, Silvia S.; Fiellin, David A.; Marshall, Brandon D.L.
In: Addiction (Abingdon, England), Vol. 111, No. 11, 01.11.2016, p. 2021-2031.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Non-medical use of prescription opioids is associated with heroin initiation among US veterans
T2 - a prospective cohort study
AU - Banerjee, Geetanjoli
AU - Edelman, E. Jennifer
AU - Barry, Declan T.
AU - Becker, William C.
AU - Cerda, Magdalena
AU - Crystal, Stephen
AU - Gaither, Julie R.
AU - Gordon, Adam J.
AU - Gordon, Kirsha S.
AU - Kerns, Robert D.
AU - Martins, Silvia S.
AU - Fiellin, David A.
AU - Marshall, Brandon D.L.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - AIMS: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care.DESIGN: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use.SETTING: Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC.PARTICIPANTS: A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012.MEASUREMENTS: The primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use.FINDINGS: Using a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR)�=�5.43, 95% confidence interval (CI)�=�4.01, 7.35].CONCLUSIONS: New-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use.
AB - AIMS: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care.DESIGN: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use.SETTING: Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC.PARTICIPANTS: A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012.MEASUREMENTS: The primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use.FINDINGS: Using a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR)�=�5.43, 95% confidence interval (CI)�=�4.01, 7.35].CONCLUSIONS: New-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use.
KW - Heroin
KW - longitudinal study
KW - non-medical prescription drug use
KW - opioid-related disorders
KW - polysubstance use
KW - veterans
UR - http://www.scopus.com/inward/record.url?scp=84990235097&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84990235097&partnerID=8YFLogxK
U2 - 10.1111/add.13491
DO - 10.1111/add.13491
M3 - Article
VL - 111
SP - 2021
EP - 2031
JO - Addiction
JF - Addiction
SN - 0965-2140
IS - 11
ER -