Featured News: What Influences Transition from Prescription Opioid Misuse to Injection Drug Use?

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A new study finds there are no significant differences between young adults who misuse prescription opioids and those who inject heroin, except for the amount of time they have used drugs.

The study of young adults in rural upstate New York found on average, it took four to five years between the time a young person started using prescription opioids and the time they started to inject drugs. “Unless they receive treatment, in another year or two it’s likely those who are misusing prescription opioids are on a trajectory to start injecting,” said lead researcher Holly Hagan PhD, MPH, RN, Professor at the NYU Rory Meyers College of Nursing and co-director of the Center for Drug Use and HIV/HCV Research. “We have to figure out how to intervene now to help these young people with their substance use problem.”

Most of the young adults in the study who were in treatment were in 12-step programs and were not receiving medication-assisted treatment. “There are few programs for methadone and buprenorphine in this area,” Dr. Hagan said. “More office-based buprenorphine treatment is needed to prevent young adults from transitioning to injection drug use. We want to reverse this cycle of drug use before it becomes too entrenched.”

Dr. Hagan found that of the 198 young adults in the study, ages 18 to 29, about half had experienced at least one overdose.

Before starting the study, Dr. Hagan thought that severe adverse childhood experiences might explain the difference between young adults who misused prescription opioids and those who injected heroin. “Adverse childhood experiences – both physical and emotional abuse – were strongly associated with having a substance use disorder,” she said. “About 65 percent of young adults in our study experienced some kind of abuse. But we found no difference in the history of abuse between those who took prescription opioids and those who injected drugs,” she said. “They are just in different stages in the evolution of their drug use – those who aren’t injecting drugs tend to be a few years younger.”

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