Does opioid misuse in teens lead to heroin use?

Teenagers who use prescription opioids in a nonprescription manner may be more likely to move onto using heroin, according to a new study published in JAMA Pediatrics.

Researchers went to 10 high schools in Los Angeles, California, and administered 8 semiannual surveys from 9th to 12th grades. The survey examined nonmedical prescription opioid use, heroin, and other factors from October 2013 to July 2017. The exposures were self-reported past-30-day use versus past-6-month prior use and 30 days without use versus no past-6-month use. The sample included 3298 students of which 1775 were adolescent girls. The demographic breakdown showed 1563 of the participants were Hispanic; 548 were Asian; 529 were non-Hispanic white; 220 were multiracial; and 155 were African American.

The average per-survey prevalence of prior and current nonmedical prescription opioid use from surveys 1 to 7 was 1.9% and 2.7%, respectively. During the duration of surveys 2 to 8, 70 students began using heroin. Both prior and current nonmedical prescription opioid use had positive associations with subsequent heroin use. The estimated cumulative probabilities of subsequent heroin use by the time of the 8th survey were 1.7% for no nonmedical prescription opioid use; 10.7% for prior use; and 13.1% for current use.

The researchers concluded that a positive association exists between current use of nonmedical prescription opioids and future heroin use. They did say that more study would be needed to determine if the link was causal.