Nonmedical Prescription Opioid Use Is Associated with Later Heroin Initiation in Teens

Adolescents commonly obtain prescription opioids from friends and family for nonmedical reasons. Cross-sectional reports have suggested an association between prior nonmedical opioid prescription use and subsequent initiation of heroin.

In a longitudinal cohort study, researchers surveyed 3396 students at 10 high schools in Los Angeles every 6 months for 42 months, starting in ninth grade. Students who had used heroin at baseline were excluded. The remaining cohort of 3298 participants was 54% girls and 48% Hispanic, 17% Asian, 16% non-Hispanic white, and 5% African-American.

Seventy students (2.1%) initiated heroin by 42 months; they were more likely to be boys and to report lower parental monitoring and higher delinquent behavior at baselin…