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Journal of Addiction Medicine:
doi: 10.1097/ADM.0b013e3181e0364e
Original Research

How Do Prescription Opioid Users Differ From Users of Heroin or Other Drugs in Psychopathology: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Wu, Li-Tzy ScD; Woody, George E. MD; Yang, Chongming PhD; Blazer, Dan G. MD, PhD

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Abstract

Objectives: To study substance use and psychiatric disorders among prescription opioid users, heroin users, and nonopioid drug users in a national sample of adults.

Methods: Analyses of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093).

Results: Four groups were identified among 9140 illicit or nonprescribed drug users: heroin-other opioid users (1.0%; used heroin and other opioids), other opioid-only users (19.8%; used other opioids but never heroin), heroin-only users (0.5%; used heroin but never other opioids), and nonopioid drug users (78.7%; used drugs but never heroin or other opioids). After adjusting for variations in socioeconomic characteristics, history of substance abuse treatment, and familial substance abuse, heroin-other opioid users had greater odds of several substance use disorders (SUDs; cocaine, hallucinogen, sedative, amphetamine, and tranquilizer) when compared with the other groups; heroin-only users had reduced odds of sedative and tranquilizer use disorders when compared with other opioid-only users. Nonopioid drug users had reduced odds of all SUDs and other mental disorders (mood, anxiety, pathologic gambling, and personality) when compared with other opioid-only users. Past-year other opioid-only users also reported slightly lower scores on quality of life than past-year nonopioid drug users.

Conclusions: All opioid users had higher rates of SUDs than nonopioid drug users, and these rates were particularly increased among heroin-other opioid users. The findings suggest the need to distinguish between these 4 groups in research and treatment as they may have different natural histories and treatment needs.

© 2011 American Society of Addiction Medicine

    

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