• Andrew C Meyer, Mollie E Miller, and Stacey C Sigmon.
• Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA.
• Addict Behav. 2015 Mar 1; 42: 189-93.

BackgroundWhile research suggests primary prescription opioid (PO) abusers may exhibit less severe demographic and drug use characteristics than primary heroin abusers, less is known about whether a lifetime history of heroin use confers greater severity among PO abusers.ObjectiveIn this secondary analysis, we examined demographic and drug use characteristics as a function of lifetime heroin use among 89 PO-dependent adults screened for a trial evaluating the relative efficacy of buprenorphine taper durations. Exploratory analyses also examined contribution of lifetime heroin use to treatment response among a subset of participants who received a uniform set of study procedures.MethodsBaseline characteristics were compared between participants reporting lifetime heroin use ≥5 (H(+); n=41) vs. <5 (H(-); n=48) times. Treatment response (i.e., illicit opioid abstinence and treatment retention at end of study) was examined in the subset of H(+) and H(-) participants randomized to receive the 4-week taper condition (N=22).ResultsH(+) participants were significantly older and more likely to be male. They reported longer durations of illicit opioid use, greater alcohol-related problems, more past-month cocaine use, greater lifetime IV drug use, and greater lifetime use of cigarettes, amphetamines and hallucinogens. H(+) participants also had lower scores on the Positive Symptom Distress and Depression subscales of the Brief Symptom Inventory. Finally, there was a trend toward poorer treatment outcomes among H(+) participants.ConclusionA lifetime history of heroin use may be associated with elevated drug severity and unique treatment needs among treatment-seeking PO abusers.Copyright © 2014 Elsevier Ltd. All rights reserved.

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