By Brenda L. Mooney
PROVIDENCE, RI—Veterans who misuse opioid painkillers have a very high risk of also beginning to use heroin, according to a new study.
The report published in the journal Addiction was based on a decade long study by researchers at Brown and Yale Universities who followed nearly 3,400 veterans who were participating in the Veterans Aging Cohort Study (VACS).1
The authors strongly urged healthcare providers who serve veterans to closely monitor them for signs of nonmedical use of opioid painkillers. They also point out that chronic pain was not found to be a significant risk factor for heroin use.
“This study quantifies the issue of starting painkiller misuse and heroin use in a specific, high-risk population—veterans around the U.S.,” explained corresponding author Brandon Marshall, PhD, Manning Assistant Professor in the Brown University School of Public Health. “Of the 500 participants who initiated heroin, 77% reported prior or concurrent nonmedical prescription painkiller use.”
Veterans who misused painkillers were 5.4 times more likely to begin using heroin than those who did not, even taking into account other risk such as race, income, use of other drugs and post-traumatic stress disorder (PTSD) or depression, according to the report.
The study focused on 3,396 VACS participants who, at the study’s beginning in 2002, said they had never used heroin or opioids for nonmedical reasons. The veterans were being treated at infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington.
“Our findings demonstrate a pattern of transitioning from nonmedical use of prescription opioids to heroin use that has only been demonstrated in select populations,” explained co-author David Fiellin, MD, a Yale public health and medical professor and director of the VACS study intervention group. “Our findings are unique in that our sample of individuals consisted of patients who were receiving routine medical care for common medical conditions.”