Prescription opioid misuse remains one of America’s biggest drug problems. In recent years the numbers of people misusing prescription pain relievers has leveled off, however, the number of people dying from overdoses continues to rise, and a new epidemic of heroin use has emerged as many people misusing prescription opioids transition to their cheaper, often easier-to-obtain street relative.

Although the links between illicit prescription opioid use and heroin use are well-established, until now no study had prospectively examined the transition to heroin use among people misusing pain medications to understand the factors that predict such a transition.

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