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INTRODUCTION: There is an established link between non-medical use of prescription drugs (NMUPD) and heroin use among adults; however, little is known about this relationship among adolescents. We investigate this association among a nationally-representative sample of U.S. high school students. METHODS: Using data from the 2013 Youth Risk Behavior Survey (n = 13,462), we ran logistic regression models with multiple imputation to examine the association between NMUPD and heroin use, while controlling for other risk behaviors and mental health problems. RESULTS: In the final adjusted model, compared to high school students reporting never misusing prescription drugs, those reporting NMUPD 1–9 times in their lives had a 1.90 times greater odds of heroin use and those reporting ≥10 times had a 5.59 times greater odds. Additionally, the following variables were significantly associated with heroin use: being male, carrying a weapon in the past 30 days, history of sexual intercourse, dating violence victimization, and reporting other drug use. CONCLUSION: NMUPD was associated with increased odds of heroin use among high school students. Future studies should investigate what other factors increase the risk of heroin use longitudinally, which is crucial to understanding how to best intervene among this population to prevent NMUPD and heroin use.

Evidence-based interventions to reduce substance misuse among adolescents are resource and time intensive. We conducted a pilot randomized controlled trial to evaluate a novel, adaptable, and resource-efficient substance misuse preventive intervention for parents/guardians, focusing on talking with children about substance use and eating family meals. We randomized 70 parents of children in third-through-sixth grades within a large, urban public school system in New England to the intervention or control condition. Over a 6-month follow-up period, we assessed feasibility and acceptability of the intervention and examined frequency of parent–child conversations about alcohol, marijuana, and other drugs, and frequency and duration of family meals. A total of 29 parents were assigned to the intervention and 35 to the control condition. The intervention was found to be feasible and acceptable to participants as evidenced by high recruitment and retention rates and positive feedback from qualitative exit interviews. At 3-month and 6-month follow up, 64.3 % and 44.5 % of parents in the intervention condition were talking “a lot” to their children about alcohol, compared to 8.7 % and 8.7 % of the parents in the control condition, respectively (p