While previous research has documented young adults are the age group with the highest rate of heroin use, yet little is known about patterns of opioid use and the transition to heroin among this group. A new, cross-sectional study investigated these risk behaviors using self-reported data from a sample of young adults (n = 539) who used opioids. Participants were recruited using Respondent-Driven Sampling, a technique designed to recruit hard-to-reach populations. Inclusion criteria were being 18 to 29 years old, living in New York City, and reporting nonmedical use of prescription opioids and/or heroin at least three times in the past 30 days. Participants reported their substance use behaviors, histories of overdosing, and demographic characteristics via computer-assisted interviews. Substance use trajectories were assessed by asking participants the ages at which they first began using a substance regularly (at least once per week for at least one month). The authors calculated descriptive statistics for the prevalence of substance use and used a series of two-tailed paired t-tests to assess differences in mean age of regular use of substances. Results indicated the generalized trajectory model for participants began with initiation of nonmedical prescription opioid use at mean age 16.8 years, followed by injection of prescription opioids at mean age 20.6 years and heroin use at mean age 20.4 years. Typical reasons for initiating prescription opioid misuse included to get high (90%), curiosity (78%), and to party and socialize with friends (50%). 83% of the sample transitioned to using heroin from prescription opioids and 64% of heroin users reported injecting it. 43% of participants disclosed overdosing at least once. 70% of the sample reporting accessing treatment, although the mean age of initiating treatment was 19.8 years. The authors concluded this study provided evidence of predictable opioid use trajectory among young adults, although they posited some behaviors (i.e., injection) may vary based on drug availability.
Take away: Results of this study suggest young adults may progress through opioid use risk behaviors in a predictable manner, beginning with nonmedical use of prescription opioids at about age 17, use of heroin at about age 20, and injecting prescription opioids at about age 21. Overdose and treatment for substance use disorders were common among this sample.