25481453
BACKGROUND	While research suggests primary prescription opioid ( PO ) abusers may exhibit less severe demographic and drug use characteristics than primary heroin abusers , less is known about whether a lifetime history of heroin use confers greater severity among PO abusers .
OBJECTIVE	In this secondary analysis , we examined demographic and drug use characteristics as a function of lifetime heroin use among 89 PO-dependent adults screened for a trial evaluating the relative efficacy of buprenorphine taper durations .
OBJECTIVE	Exploratory analyses also examined contribution of lifetime heroin use to treatment response among a subset of participants who received a uniform set of study procedures .
METHODS	Baseline characteristics were compared between participants reporting lifetime heroin use 5 ( H ( + ) ; n = 41 ) vs. < 5 ( H ( - ) ; n = 48 ) times .
METHODS	Treatment response ( i.e. , illicit opioid abstinence and treatment retention at end of study ) was examined in the subset of H ( + ) and H ( - ) participants randomized to receive the 4-week taper condition ( N = 22 ) .
RESULTS	H ( + ) participants were significantly older and more likely to be male .
RESULTS	They reported longer durations of illicit opioid use , greater alcohol-related problems , more past-month cocaine use , greater lifetime IV drug use , and greater lifetime use of cigarettes , amphetamines and hallucinogens .
RESULTS	H ( + ) participants also had lower scores on the Positive Symptom Distress and Depression subscales of the Brief Symptom Inventory .
RESULTS	Finally , there was a trend toward poorer treatment outcomes among H ( + ) participants .
CONCLUSIONS	A lifetime history of heroin use may be associated with elevated drug severity and unique treatment needs among treatment-seeking PO abusers .

