Search

Rates and patterns of transition from opioid analgesic to illicit opioid (ie, heroin) use is of great clinical significance. Exposure to opioid analgesics, and whether use is therapeutic or outside a doctor's orders, may have overlapping yet different patterns of transition to heroin use. Yet, this topic is rarely examined in longitudinal studies. With data from the landmark Monitoring the Future (MTF) study, McCabe and colleagues have now studied the transition from adolescent use of opioid analgesics (both medical and nonmedical) to heroin over a seventeen year follow up for adolescents first recruited from 1975 to 2000. Key findings include an overall association of both nonmedical and medical use of opioid analgesics with transition to heroin use, with particular concerns about early nonmedical use. Of note, more recent cohorts apparently have an increased risk of transition to heroin, suggesting a need for minimizing opioid prescribing and for screening of youth and young adults for prior nonmedical opioid analgesic use before prescribing opioids. New research is also suggested to address such questions as: What is the time course of exposure to the start of heroin use? How does the frequency and dosage of exposure matter? Continued analyses of MTF data, as well as exploration of other data are needed to address these and related compelling issues. [ABSTRACT FROM AUTHOR]

The article discusses research done on accuracy in reporting past psychiatric symptoms. It references the study "Accuracy of Reports of Lifetime Mental and Physical Disorders: Results From the Baltimore Epidemiological Catchment Area Study" by Y. Takayanagi and colleagues published online in the January 8, 2013 issue. The authors of the study are applauded for identifying an important limitation in cross-sectional studies.

In the 50 years since its establishment, the National Institute on Drug Abuse has made significant investment and strides toward improving individual and public health. Epidemiology serves as the foundation for understanding the how many, why, how, where, and who of drug use and its consequences, and effective epidemiology research and training are geared toward actionable findings that can inform real-world responses. Epidemiologic findings enhance clinicians' ability to provide ongoing care by incorporating information about the patterns and outcomes of drug use that their patients may experience. The goal of this article is to provide a context for epidemiology of substance use as a foundation for prevention, with examples of how epidemiology can provide targets for prevention, and to set the stage for addressing the importance of prevention in clinical settings., Competing Interests: Dr. Parker reports investment holdings in Putnam Global Health Care Fund Class A (PHSTX). The other authors report no financial relationships with commercial interests., (Copyright © 2024 by the American Psychiatric Association.)