Evidence map›Paper›PMID 30107320›Full record

ArticleDrug and alcohol dependence2018

Predictors of transitions across stages of heroin use and dependence prior to treatment-seeking among people in treatment for opioid dependence.

Briony Larance, Natasa Gisev, Elena Cama, Elliot C Nelson, Shane Darke, Sarah Larney, Louisa Degenhardt

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In one paragraph

Article in Drug and alcohol dependence, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Briony LaranceNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia. Electronic address: b.larance@unsw.edu.au.
Natasa GisevNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.
Elena CamaNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.
Elliot C NelsonWashington University, School of Medicine, Department of Psychiatry, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA.
Shane DarkeNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.
Sarah LarneyNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.
Louisa DegenhardtNational Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.

Funding

Opioid Dependence: Candidate Genes and G x E EffectsR01DA017305 · NIDA · WASHINGTON UNIVERSITY · PI NELSON, ELLIOT C · 2003 to 2007
$2.5M
Using existing data to understand and ameliorate risk in opioid agonist therapyR01DA044170 · NIDA · UNIVERSITY OF NEW SOUTH WALES · PI DEGENHARDT, LOUISA · 2017 to 2019
$641k
NIDA NIH HHS R01 DA017305NIDA NIH HHS R01 DA044170
6 · The paper itself

Abstract

BACKGROUND AND

aimsLittle is known about transition pathways among heroin users prior to treatment. This study examined the demographic and clinical predictors of transition speed from heroin use, to dependence, to first treatment episode.

methods1149 heroin-dependent participants recruited from opioid agonist treatment clinics in Sydney, Australia, underwent a structured interview. Age of onset (AOO) was collected for heroin use, dependence and treatment-seeking, childhood maltreatment, psychiatric history and other substance dependence. Discrete-time survival analyses modelled years from onset of use to dependence, and from dependence to treatment-seeking, including demographic and clinical covariates.

findingsMedian AOO for first heroin use, dependence and treatment-seeking was 18 years (inter-quartile range, or IQR = 6), 21 years (IQR = 7), and 24 years (IQR = 10) respectively. In adjusted models, younger birth cohorts (vs. born <1960), greater childhood maltreatment and later AAO of first heroin use were associated with more rapid transitions from heroin use to dependence. Living independently, parental violence, and alcohol dependence were associated with slower transitions. Earlier treatment-seeking was associated with younger birth cohorts, having dependent children and later AOO of dependence. Delayed treatment-seeking was associated with <10 years school education, living independently, depression and alcohol dependence.

conclusionsIn this treatment sample, onset of heroin use occurred during late adolescence, suggesting the need for targeted interventions in mid-adolescence. Transitions to heroin dependence, then treatment-seeking, occurred during early adulthood. Rapid transitions from use to dependence were associated with younger birth cohorts, greater exposure to childhood maltreatment, and later onset of use.

Indexed as

AdolescentAdultAdult Survivors of Child AbuseAge FactorsAge of OnsetFemaleHeroin DependenceHumansMaleMiddle AgedNew South WalesPatient Acceptance of Health CareSubstance Abuse Treatment CentersTime FactorsTime-to-TreatmentYoung AdultHeroinOpioid dependenceOpioid use disordersTreatment-seeking

Identifiers

PMID30107320
PMCPMC6698181

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.