Nonmedical opioid users are more likely to start abusing the drug after getting them from friends or family members—not doctors—according to a new study.

Many people may think heroin abuse begins after doctors prescribe opioids and patients become addicted to them. When the government cracked down on prescription opioids and drug manufacturers began making pills more difficult to get in the late 2000s, users then transitioned to heroin because of its lower price and higher relative availability.

But in a series of in-depth interviews with 30 opioid users from southwestern Pennsylvania, about 56 percent said they began using the painkillers recreationally first, says Ashton Verdery, assistant professor of sociology, demography, and social data analytics at Penn State and an affiliate of the Institute for CyberScience.

“There’s a lot about that narrative that I think is an overly simplistic way of thinking about this,” Verdery says. “What emerged from our study—and really emerged because we decided to do these qualitative interviews in addition to a survey component—was a pretty different narrative than the national one.

“We found that most people initiated through a pattern of recreational use because of people around them. They got them from either siblings, friends, or romantic partners.”

Some study participants did say that they later engaged in “doctor shopping” to locate new sources of prescription pills when acquiring pills from those initial sources became more difficult, he adds.

GET THE WARNING OUT

Understanding this pathway may help improve interventions and treatment options, the researchers say. The study appears in the Journal of Addictive Studies.

“It’s not just that people were prescribed painkillers from a doctor for a legitimate reason and, if we just crack down on the doctors who are prescribing in these borderline cases we can reduce the epidemic,” Verdery says.

“Our results really don’t speak to that framework. They speak more to the need of educating people how dangerous these pills are and warning them about getting the pills from friends and family, because that’s the way a lot of people are getting addicted.”

INTERVIEWS FROM THE EPIDEMIC

Researchers first recruited 125 participants to complete a survey that sought information on their demographics, substance use, social networks, and risk factors. A total of 30 survey participants accepted an invitation to then take part in semi-structured, in-depth interviews that lasted about an hour.

The researchers conducted interviews with nonmedical opioid users from rural and urban southwestern Pennsylvania—a region that the opioid epidemic has hit particularly hard.

Verdery suggests that the researchers would find similar results in other areas hit by the epidemic. Future research may explore addiction pathways in other communities and consider how other substance use may play a role in opioid addiction.

“We think that understanding this mechanism as a potential pathway is worth further consideration,” Verdery says. “At the same time, friends and family are critical resources that people who use opioids can draw on for support and help in seeking treatment, which is all the more reason to pay attention to how drug use affects and is affected by social relationships.”

Additional coauthors are from Penn State, the University of South Florida, and Syracuse University.

Penn State’s Population Research Institute, Social Science Research Institute and Justice Center for Research, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the USDA National Institute of Food and Agriculture supported the work.

Source: Penn State