Heroin & Other Illicit Drugs
Heroin or illicit synthetic opioids now account for the majority of opioid-related overdoses. Some individuals who use heroin report prescription opioid misuse prior to heroin initiation, and there is concern that patients may turn to heroin after regular exposure to prescribed opioids and non-patient-centered opioid dosage tapering. This session aims to inform public health and policy efforts to reduce risk of heroin initiation and overdose.
In this session, speakers will: (1) describe and summarize the latest trend in opioid overdose, current knowledge and research gaps around initiation of and/or transition to illicit opioid use, and CDC’s research activities related to this topic; and (2) describe results of two studies examining opioid prescription histories among individuals who experienced a heroin overdose. In the first study, heroin overdoses (n=3,183) were examined in claims data from a large, national commercial insurer during 2010-2017. Few were prescribed opioids immediately prior to the overdose, but 42.3% were prescribed opioids in the prior year and 14.1% had a chronic pain diagnosis. Among those with opioid use, 37.5% had dosages above 90 MME. The second study used linked Oregon Medicaid, prescription drug monitoring program, and vital statistics data from 2014-2017 to compare prescribed opioid use prior to fatal or non-fatal heroin overdose (n=1,458) to other opioid overdose (n=2,050; synthetics excluded). Although overdose risk factors (i.e. opioid-benzodiazepine overlap, multiple pharmacies/prescribers) were less common among heroin overdoses than other opioid overdoses, nearly half (45%) filled an opioid in the year prior. Chronic opioid use (>=90 days of use) was relatively uncommon (5%) in the year prior to overdose. Both studies also will present methodologic approaches and results characterizing prescribed opioid dose reduction and discontinuation prior to overdose.
This session is accredited for the following accreditation types: CME, CNE, CPE, APA, AAFP, AAHCPAD*, NAADAC*, ASWB*
*State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit.