Non-medical use of prescription drugs and its association with heroin use among high school students

Introduction: There is an established link between non-medical use of prescription drugs (NMUPD) and heroin use among adults; however, little is known about this relationship among adolescents. We investigate this association among a nationally-representative sample of U.S. high school students. Methods: Using data from the 2013 Youth Risk Behavior Survey (n = 13,462), we ran logistic regression models with multiple imputation to examine the association between NMUPD and heroin use, while controlling for other risk behaviors and mental health problems. Results: In the final adjusted model, compared to high school students reporting never misusing prescription drugs, those reporting NMUPD 1-9 times in their lives had a 1.90 times greater odds of heroin use and those reporting >= 10 times had a 5.59 times greater odds. Additionally, the following variables were significantly associated with heroin use: being male, carrying a weapon in the past 30 days, history of sexual intercourse, dating violence victimization, and reporting other drug use. Conclusion: NMUPD was associated with increased odds of heroin use among high school students. Future studies should investigate what other factors increase the risk of heroin use longitudinally, which is crucial to understanding how to best intervene among this population to prevent NMUPD and heroin use.