“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting

Examining the Relationship between Social Context and Prescription Opioid Initiation Routes among Young Adults Entering Medical Detoxification

“…Similar to other findings of those trying prescription medications for the first time, some of our participants reported misusing their own legitimate prescriptions [5,8,16,20]. Among our sample, young men with sport injuries tended to initiate via oral routes and in isolation; it is likely that peers norms associated with use learned within a social context seem to create a situation by which alternate routes are taught by others.…”

“…It is also important to note that, similar to other studies of young adult prescription drug initiates, none of our participants reported concern about the safety of misusing POs. Research among young adult samples has documented the perception that prescription medications are purer, less harmful, and safer to use [8,16,18,28]. Although young adult PO users may benefit from early education related to the potential addictive properties of POs, our findings highlight how misconceptions related to the safety of PO misuse can create a significant challenge to PO drug misuse prevention efforts.…”

“…POs have also been cited as involved in 67.8% of all reported U.S. emergency department overdoses [3]; for young adults, narcotic pain relievers were the second most common drug involved in drug related emergency department visits. Other emerging data based on drug injecting, young adult samples also suggest that POs are often the precursor to heroin abuse, thereby contributing to high risk behaviors including transition to injection [4][5][6][7][8][9][10].…”

“…snorting, smoking), with many subsequently transitioning to high risk behaviors including injection [12,15]. Further, much of the research on alternate routes of administration has focused the use of POs prior to initiation of heroin use/ and or injection drug use [5,8,10].…”

Nonmedical Use of Prescription Drugs and Sexual Risk Behaviors

“…[27][28][29] Furthermore, IDU is an important behavioral covariate, as it has been associated with HIV infection and SRBs and may be related to NMUPD: NMUPD has been implicated as a gateway behavior for later IDU. [29][30][31] However, adjusting for highly correlated variables introduced a concern for multicollinearity in our models. Therefore, we assessed multicollinearity by calculating the variance inflation factor for each model and did not observe values that were outside of an acceptable range.…”