Our findings that heroin and other illicit drug use has increased in recent years among persons with POUD are consistent with those of previous studies (14, 15), and provide further evidence that persons with prescription opioid addiction have moved towards more potent and potentially dangerous opioids and other illicit drugs to maintain their addiction. Our finding that heroin use significantly increased over time among persons in general population, specifically in persons without a prescription opioid or heroin use disorder may reflect another unintended consequence of a decreasing prescription opioid supply availability in the context of increased heroin supply.
