A new study suggests abuse of prescription painkillers is often a precursor to the use of injected drugs such as heroin, among people with a history of using both types of drugs.
Researchers at Drexel University’s School of Public Health found that a family history of drug misuse and receiving prescriptions for opioid drugs were additional factors for injected drug use.
The study, published in the International Journal of Drug Policy, explores factors surrounding young injection drug users’ initiation into the misuse of opioid drugs.
“Participants were commonly raised in households where misuse of prescription drugs, illegal drugs, or alcohol, was normalized,” said Dr. Stephen Lankenau.
“Access to prescription medications – either from a participant’s own source, a family member, or a friend – was a key feature of initiation into prescription drug misuse.”
Researchers also discovered the desire to experiment with a prescription opioid drug (the common class of drugs that includes codeine and oxycodone), combined with financial incentives or pressures from friends to sell available quantities, resulted in escalated patterns of opioid misuse.
Lankenau and colleagues also describe two key findings as evidence of an emerging dynamic among misuse of opioid drugs and the use of injection drugs.
First, four of five injected drug users (IDUs) abused an opioid before injecting heroin, in contrast to more conventional patterns of using opioids as a substitute drug after initiating heroin use.
Second, in nearly one out of four young IDUs in this study, a prescription opioid was the first type of drug they injected.
Prescription opioids are rarely reported at initiation into injection drug use amongst young IDUs. All but two of these participants later transitioned into injecting heroin.
Experts say that opioid misuse is an important public health concern due to the increasing association of opioids with drug dependence and fatal overdose. However, researchers have little information on prescription opioid misuse among young injection drug users.
To fill this gap, researchers interviewed 50 young IDUs aged 16 and 25 years old in New York and Los Angeles, who had misused a prescription drug at least three times in the past three months.
Participants were recruited in natural settings, such as parks, streets, and college campuses, during 2008 and 2009. A mixed-methods research design was utilized that collected both quantitative and qualitative data.
Additional findings and descriptors of the study population include:
- Most were white, heterosexual males in their early 20s;
- Many did not complete high school, were expelled from school, or held back a grade;
- Nearly all were homeless at some point, most were currently homeless, and most regarded themselves as “travelers,” (i.e., moving from city to city in search of work, housing, or adventure);
- Most had received a psychological diagnosis, such as depression, anxiety, or Attention Deficit Hyperactivity Disorder (ADHD), and many had a history of drug treatment;
- Most generally regarded prescription opioids as readily accessible, valued commodities that could be traded or sold;
- Nearly three-quarters had been prescribed an opioid in their lifetime, which occurred on average at 14.6 years old, often for common ailments such as dental procedures or sports injuries;
- Most witnessed family members misuse one or more substances during childhood and adolescence, ranging from alcoholism to injecting heroin.
From these findings, researchers believe prevention efforts, especially during adolescence, are needed.
Further, parents and guardians need to carefully monitor and safeguard all prescription medications, particularly opioids, within the household. Researchers admit that the task is more difficult among households where drug use is a standard occurrence.
Furthermore, experts call for future research examining prescription opioid misuse among a range of adolescents and young adults is necessary to better understand the environmental factors of drug use.
Source: Drexel University