• Silvia S Martins, Julian Santaella-Tenorio, Brandon D L Marshall, Adriana Maldonado, and Magdalena Cerdá.
• Department of Epidemiology, Columbia University, New York, NY, USA. Electronic address: ssm2183@columbia.edu.
• Drug Alcohol Depend. 2015 Jun 1;151:278-83.

BackgroundThis study examines changing patterns of past-year heroin use and heroin-related risk behaviors among individuals with nonmedical use of prescription opioids (NMUPO) by racial/ethnic groups in the United States.MethodsWe used data from the National Survey on Drug Use and Health (NSDUH) from 2002 to 2005 and 2008 to 2011, resulting in a total sample of N = 448,597.ResultsPast-year heroin use increased among individuals with NMUPO and increases varied by frequency of past year NMUPO and race/ethnicity. Those with NMUPO in the 2008-2011 period had almost twice the odds of heroin use as those with NMUPO in the 2002-2005 period (OR = 1.89, 95%CI: 1.50, 2.39), with higher increases in non-Hispanic (NH) Whites and Hispanics. In 2008-2011, the risk of past year heroin use, ever injecting heroin, past-year heroin abuse or dependence, and the perception of availability of heroin increased as the frequency of NMUPO increased across respondents of all race/ethnicities.ConclusionIndividuals with NMUPO, particularly non-Hispanic Whites, are at high risk of heroin use and heroin-related risk behaviors. These results suggest that frequent nonmedical users of prescription opioids, regardless of race/ethnicity, should be the focus of novel public health efforts to prevent and mitigate the harms of heroin use.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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