{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:24:32Z","timestamp":1769315072052,"version":"3.49.0"},"reference-count":23,"publisher":"Emerald","issue":"1","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["DHS"],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title>\n<jats:p>The emergence of fentanyl has deepened concerns about the opioid crisis. The shift has created new distinctions in patterns of opioid use, which may be important for prevention and intervention. This paper aims to examine sociodemographic correlates as well as health and substance use characteristics of different groups of opioid users.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title>\n<jats:p>This paper used the 2015\u20132019 National Survey on Drug Use and Health to examine distinctions between groups (<jats:italic>n<\/jats:italic> = 11,142) of individuals who misuse prescription opioids, use heroin but not fentanyl, misuse pharmaceutical fentanyl but not heroin and use both heroin and fentanyl. Multinomial and logistic regression models were used to identify these distinctions.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Findings<\/jats:title>\n<jats:p>Few sociodemographic differences emerged between the prescription opioid group and pharmaceutical fentanyl misuse group. While those who misuse fentanyl have higher odds of using other drugs and experiencing certain mental health problems than those misusing prescription pills, both the heroin and fentanyl\u2013heroin use groups reported considerably poorer health and substance use indicators relative to those who solely misuse fentanyl. It is also notable that both heroin use groups are more highly associated with cocaine and methamphetamine use than those misusing fentanyl alone.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Research limitations\/implications<\/jats:title>\n<jats:p>While this study identifies important distinctions between the opioid use groups studied, individuals using both heroin and pharmaceutical fentanyl report the poorest health and substance use characteristics. Important differences between the fentanyl-only group and the group who consume both drugs may have implications for prevention, intervention and clinical work amid shifting patterns of opioid use.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Practical implications<\/jats:title>\n<jats:p>Important differences between the fentanyl-only group and the group who consume both drugs may have implications for prevention, intervention and clinical work amid shifting patterns of opioid use.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title>\n<jats:p>This study highlights distinctions between pharmaceutical fentanyl users, heroin users and users of both substances.<\/jats:p>\n<\/jats:sec>","DOI":"10.1108\/dhs-04-2022-0019","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T11:25:11Z","timestamp":1663673111000},"page":"14-25","source":"Crossref","is-referenced-by-count":4,"title":["Correlates of heroin use, pharmaceutical fentanyl misuse, and dual heroin-fentanyl use: evidence from the USA"],"prefix":"10.1108","volume":"24","author":[{"given":"Brian C.","family":"Kelly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Vuolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"key2023022817082123600_ref001","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.addbeh.2015.05.001","article-title":"Co-occurrence between mental distress and poly-drug use: a ten year prospective study of patients from substance abuse treatment","volume":"48","year":"2015","journal-title":"Addictive Behaviors"},{"issue":"5","key":"key2023022817082123600_ref002","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1080\/00952990.2020.1771721","article-title":"Changes in drug use behaviors coinciding with the emergence of illicit fentanyl among people who use drugs in Vancouver, Canada","volume":"46","year":"2020","journal-title":"The American Journal of Drug and Alcohol Abuse"},{"issue":"2","key":"key2023022817082123600_ref003","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/add.14451","article-title":"Polydrug use patterns and their impact on relapse among heroin\u2010dependent patients in Shanghai, China","volume":"114","year":"2019","journal-title":"Addiction"},{"key":"key2023022817082123600_ref004","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.drugpo.2017.06.010","article-title":"Fentanyl in the US heroin supply: a rapidly changing risk environment","volume":"46","year":"2017","journal-title":"International Journal of Drug Policy"},{"key":"key2023022817082123600_ref005","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.drugpo.2019.01.010","article-title":"The triple wave epidemic: supply and demand drivers of the US opioid overdose crisis","volume":"71","year":"2019","journal-title":"International Journal of Drug Policy"},{"issue":"4","key":"key2023022817082123600_ref006","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/YCO.0000000000000717","article-title":"The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis","volume":"34","year":"2021","journal-title":"Current Opinion in Psychiatry"},{"issue":"3","key":"key2023022817082123600_ref007","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1360-0443.1996.tb02289.x","article-title":"Overdose among heroin users in Sydney, Australia: i. prevalence and correlates of non\u2010fatal overdose","volume":"91","year":"1996","journal-title":"Addiction"},{"issue":"6","key":"key2023022817082123600_ref008","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1080\/09595230801956124","article-title":"Comparing heroin users and prescription opioid users in a Canadian multi-site population of illicit opioid users","volume":"27","year":"2008","journal-title":"Drug and Alcohol Review"},{"key":"key2023022817082123600_ref009","doi-asserted-by":"crossref","first-page":"S314","DOI":"10.1111\/dar.12668","article-title":"Intravenous fentanyl use among people who inject drugs in Australia","volume":"37","year":"2018","journal-title":"Drug and Alcohol Review"},{"key":"key2023022817082123600_ref010","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.drugalcdep.2019.01.031","article-title":"Polydrug use disorders in individuals with opioid use disorder","volume":"198","year":"2019","journal-title":"Drug and Alcohol Dependence"},{"key":"key2023022817082123600_ref011","doi-asserted-by":"crossref","first-page":"109001","DOI":"10.1016\/j.drugalcdep.2021.109001","article-title":"Drug overdose deaths involving cocaine and psychostimulants with abuse potential among racial and ethnic groups \u2013 United States, 2004\u20132019","volume":"227","year":"2021","journal-title":"Drug and Alcohol Dependence"},{"key":"key2023022817082123600_ref012","first-page":"109003","article-title":"Transition from injecting opioids to smoking fentanyl in San Francisco, California","volume":"277","year":"2021","journal-title":"Drug and Alcohol Dependence"},{"key":"key2023022817082123600_ref013","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.addbeh.2017.01.014","article-title":"Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically","volume":"68","year":"2017","journal-title":"Addictive Behaviors"},{"key":"key2023022817082123600_ref014","doi-asserted-by":"crossref","first-page":"108089","DOI":"10.1016\/j.drugalcdep.2020.108089","article-title":"Trends in characteristics of individuals who use methamphetamine in the United States, 2015-2018","volume":"213","year":"2020","journal-title":"Drug and Alcohol Dependence"},{"key":"key2023022817082123600_ref015","doi-asserted-by":"crossref","first-page":"108416","DOI":"10.1016\/j.drugalcdep.2020.108416","article-title":"Fentanyl and fentanyl analogs in the illicit stimulant supply: results from US drug seizure data, 2011\u20132016","volume":"218","year":"2021","journal-title":"Drug and Alcohol Dependence"},{"issue":"2","key":"key2023022817082123600_ref016","first-page":"435","article-title":"Trends in transdermal fentanyl utilisation and fatal fentanyl overdose across Australia (2003\u20132015)","volume":"41","year":"2021","journal-title":"Drug and Alcohol Review"},{"issue":"10","key":"key2023022817082123600_ref017","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1111\/add.15458","article-title":"Heroin use cannot be measured adequately with a general population survey","volume":"116","year":"2021","journal-title":"Addiction (Abingdon, England)"},{"key":"key2023022817082123600_ref018","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.addbeh.2015.07.013","article-title":"Comparing characteristics of prescription painkiller misusers and heroin users in the United States","volume":"51","year":"2015","journal-title":"Addictive Behaviors"},{"key":"key2023022817082123600_ref019","doi-asserted-by":"crossref","first-page":"107779","DOI":"10.1016\/j.drugalcdep.2019.107779","article-title":"The rapidly changing US illicit drug market and the potential for an improved early warning system: evidence from Ohio drug crime labs","volume":"208","year":"2020","journal-title":"Drug and Alcohol Dependence"},{"issue":"3","key":"key2023022817082123600_ref020","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/dar.12033","article-title":"Trends in fentanyl prescriptions and fentanyl\u2010related mortality in Australia","volume":"32","year":"2013","journal-title":"Drug and Alcohol Review"},{"key":"key2023022817082123600_ref021","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.addbeh.2019.04.022","article-title":"The epidemiology of prescription fentanyl misuse in the United States","volume":"96","year":"2019","journal-title":"Addictive Behaviors"},{"key":"key2023022817082123600_ref022","doi-asserted-by":"crossref","first-page":"108162","DOI":"10.1016\/j.drugalcdep.2020.108162","article-title":"Substance use patterns and health profiles among US adults who use opioids, methamphetamine, or both, 2015-2018","volume":"214","year":"2020","journal-title":"Drug and Alcohol Dependence"},{"issue":"1","key":"key2023022817082123600_ref023","first-page":"e1918514-e1918514","article-title":"Evaluation of trends of near-real-time urine drug test results for methamphetamine, cocaine, heroin, and fentanyl","volume":"3","year":"2020","journal-title":"JAMA Network Open"}],"container-title":["Drugs, Habits and Social Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/DHS-04-2022-0019\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/DHS-04-2022-0019\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T23:05:47Z","timestamp":1753398347000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/dhs\/article\/24\/1\/14-25\/41939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,22]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,9,22]]},"published-print":{"date-parts":[[2023,3,1]]}},"alternative-id":["10.1108\/DHS-04-2022-0019"],"URL":"https:\/\/doi.org\/10.1108\/dhs-04-2022-0019","relation":{},"ISSN":["2752-6739","2752-6747"],"issn-type":[{"value":"2752-6739","type":"print"},{"value":"2752-6747","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,22]]}}}