Comparison of heroin and fentanyl use in US nationally representative surveys
Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. H...
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| Published in: | Addiction science & clinical practice Vol. 20; no. 1; pp. 13 - 9 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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London
BioMed Central
11.02.2025
BioMed Central Ltd Springer Nature B.V BMC |
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| ISSN: | 1940-0632, 1940-0640, 1940-0640 |
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| Abstract | Background
Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy.
Methods
We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024.
Results
NSDUH (
n
= 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (
N
= 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys.
Conclusions and relevance
The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. |
|---|---|
| AbstractList | Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy.BACKGROUNDGiven the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy.We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024.METHODSWe conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024.NSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys.RESULTSNSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys.The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use.CONCLUSIONS AND RELEVANCEThe estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy. Methods We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024. Results NSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys. Conclusions and relevance The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. Abstract Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy. Methods We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024. Results NSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys. Conclusions and relevance The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. BackgroundGiven the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy.MethodsWe conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024.ResultsNSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys.Conclusions and relevanceThe estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy. We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024. NSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys. The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy. Methods We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024. Results NSDUH ( n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx ( N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys. Conclusions and relevance The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy. We conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024. NSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys. The estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use. |
| Audience | Academic |
| Author | Rockhill, Karilynn M. Dart, Richard C. Christine, Paul J. Black, Joshua C. LeMasters, Katherine Pytell, Jarratt D. Binswanger, Ingrid A. |
| Author_xml | – sequence: 1 givenname: Jarratt D. surname: Pytell fullname: Pytell, Jarratt D. email: Jarratt.Pytell@cuanschutz.edu organization: Division of General Internal Medicine, University of Colorado School of Medicine, Department of General Internal Medicine, Denver Health Hospital Authority, Institute for Health Research, Kaiser Permanente Colorado, Department of Medicine, University of Colorado School of Medicine – sequence: 2 givenname: Paul J. surname: Christine fullname: Christine, Paul J. organization: Division of General Internal Medicine, University of Colorado School of Medicine, Department of General Internal Medicine, Denver Health Hospital Authority – sequence: 3 givenname: Katherine surname: LeMasters fullname: LeMasters, Katherine organization: Division of General Internal Medicine, University of Colorado School of Medicine, Department of Epidemiology, School of Public Health, University of Colorado Medical Campus – sequence: 4 givenname: Karilynn M. surname: Rockhill fullname: Rockhill, Karilynn M. organization: Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority – sequence: 5 givenname: Joshua C. surname: Black fullname: Black, Joshua C. organization: Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority – sequence: 6 givenname: Richard C. surname: Dart fullname: Dart, Richard C. organization: Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Department of Emergency Medicine, University of Colorado School of Medicine – sequence: 7 givenname: Ingrid A. surname: Binswanger fullname: Binswanger, Ingrid A. organization: Division of General Internal Medicine, University of Colorado School of Medicine, Institute for Health Research, Kaiser Permanente Colorado, Chemical Dependency Treatment Services, Colorado Permanente Medical Group, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine |
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| PublicationDate | 2025-02-11 |
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| PublicationDecade | 2020 |
| PublicationPlace | London |
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| PublicationTitle | Addiction science & clinical practice |
| PublicationTitleAbbrev | Addict Sci Clin Pract |
| PublicationTitleAlternate | Addict Sci Clin Pract |
| PublicationYear | 2025 |
| Publisher | BioMed Central BioMed Central Ltd Springer Nature B.V BMC |
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Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The... Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National... Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The... BackgroundGiven the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The... Abstract Background Given the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation... |
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| SubjectTerms | Adjuvants Adolescent Adult Adults Age differences Alcohol Analgesics, Opioid Benzodiazepines Comorbidity Consent Cross-Sectional Studies Data collection Demography Deployment Drug abuse Drug overdose Drug use Drugs Employment Estimates Ethnicity Female Fentanyl Health Psychology Health Surveys Heroin Heroin Dependence - epidemiology Households Humans Male Medical treatment Medicine Medicine & Public Health Methadone Middle Aged Mitigation Narcotics Opioid-Related Disorders - epidemiology Opioids Overdose Pharmacology/Toxicology Polls & surveys Prescribing Prescription drugs Psychopharmacology Public Health Regression analysis Respondents Sampling Social Work Socioeconomic factors Substance abuse Substance use disorder Surveillance Toxicology United States - epidemiology Young Adult |
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| Title | Comparison of heroin and fentanyl use in US nationally representative surveys |
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