Conference Coverage

Think local when assessing adolescent heroin use


AT CPDD 2018

– Between 1999 and 2015, heroin use increased among high school students who live in Milwaukee, Chicago, and New York – trends that accompanied a rise in injection drug use in those cities.

“This implies that a subset of these students who are using heroin are probably injecting heroin as well; otherwise these trends wouldn’t be mirroring each other so well,” lead study author Sherri-Chanelle Brighthaupt said in an interview at the annual meeting of the College on Problems of Drug Dependence.

Sherri-Chanelle Brighthaupt, a third-year doctoral student in the department of mental health at Johns Hopkins University, Baltimore Doug Brunk/MDedge News

Sherri-Chanelle Brighthaupt

The finding comes from a trend analysis of heroin use and injection drug use in nine urban U.S. school districts drawn from Youth Risk Behavior Survey (YRBS) data from 1999-2015. The analysis was conducted using data from New York City, three Florida counties (Broward, Orange, and Miami-Dade), Dallas, Chicago, Milwaukee, and two California cities (San Diego and San Bernardino). “This is one of the first studies we know of that’s looking at adolescent heroin and injection drug use at the local level,” said Ms. Brighthaupt, a third-year doctoral student in the department of mental health at Johns Hopkins University, Baltimore. “National estimates may mask variation at the local level.”

The sample population studied included local-level YRBS responses from 260,952 students in grades 9-12. All responses were weighted by sex, grade, and race/ethnicity, and the researchers used logistic regression models to test for liner and quadratic trends in the pooled sample and in each city. Between 1999 and 2015, lifetime heroin use among this population increased significantly, from 2.8% to 7.4% in Milwaukee (P = .0001), from 3.1% to 4.1% in Chicago (P = .02), and from 1% to 2.5% in New York (P less than .0001). However, during the same time frame, heroin use decreased in San Bernardino from 4.6% to 1.6% (P = .0001).

The researchers also found that between 1999 and 2015, lifetime injection drug use in this age group increased significantly, from 0.8% to 2.2% in New York (P less than .0001) and from 2.5% to 2.7% in Chicago (P = .05). During the same time period, lifetime injection drug use decreased in San Bernardino, (from 2.5% to 1.9%; P = .05) and in Dallas after peaking in 2007 (from 3.6% to 1%; P = .02).

“The take-home message is to look locally,” Ms. Brighthaupt said. “Some cities may have a historically entrenched culture of heroin use, and prevention and intervention efforts should be tailored to the unique social and cultural context of the geographic region.”

The research was supported by grants from the National Institute on Drug Abuse. Ms. Brighthaupt reported having no financial disclosures.

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