Nonmedical Opioid Use in Relation to Recency of Heroin Use in a Nationally Representative Sample of Adults in the United States.

Nonmedical opioid use has been linked to lifetime heroin use; however, research is needed to examine associations between nonmedical opioid use and current or recent heroin use, as current users appear to be at highest risk for harm. Data were from a nationally representative sample of non-institutionalized adults (age 18-64) in households participating in the National Survey of Drug Use and Health who reported lifetime heroin use (2005-2014, N = 7,111). We examined associations between frequency and recency of nonmedical opioid use and recency of heroin use. Most (86.7%) lifetime heroin users reported no heroin use in the last 12 months, while 6.1% reported current use (use in the last 30 days). The majority of the sample (69.3%) reported lifetime nonmedical opioid use; 14.3% reported nonmedical use in the last 30 days. Adjusted odds for current heroin use increased as frequency of past-year nonmedical opioid use increased, with a quarter (24.7%) of current heroin users reporting nonmedical opioid use on 157-365 days in the last year. Over half (54.7%) of current heroin users reported current nonmedical opioid use. Prevention efforts should consider that high-frequency and current nonmedical opioid use is a robust correlate of continued heroin use.