Abstract
Background and aimsData on rates of prescription opioid use disorder (pOUD) in European countries is limited. The aim of this investigation was to analyze a representative population sample regarding the 1-year prevalence of opioid use disorder in patients who received prescription opioid pain therapy and to identify related risk factors.DesignCross-sectional secondary data analysisSettingSecondary data analysis based on data from the 2015 Epidemiological Survey of Substance Abuse (ESA 2015) in GermanyParticipantsGerman-speaking individuals living in private households aged 18 to 64 years were investigated. A total of 9204 individuals participated in the survey, resulting in a response rate of 52.2%.Primary and secondary outcome measuresPrimary outcome measure was the weighted prevalence of pOUD in the subgroup of study participants who had received prescription opioids. Secondary outcome measure was an analysis of risk factors connected with pOUD in the same subgroup.FindingsA total of n = 9204 participants were included in the study of which n = 275 had received an opioid prescription in the last 12 months of which n = 54 were diagnosed with pOUD. The weighted 1-year prevalence of pOUD was 21.2% (mild: 14.7% | moderate: 3.5% | severe: 2.9%). Participants who had received opioid pain therapy had significantly higher odds of pOUD if they reported signs of depression (OR: 2.69; CI 95%: 1.13–6.38), inexplicable physical complaints (OR: 2.68; CI 95%: 1.14–6.31) or a psychiatric diagnosis (OR: 4.12; CI 95%: 1.36–12.43), and significantly lower odds of pOUD if they reported the use of non-opioid painkillers (OR: 0.27; CI 95%: 0.09–0.81).ConclusionspOUD is a common phenomenon in working-age patients who receive prescription opioid pain therapy in Germany and may be related to the co-existence of psychosomatic and psychiatric disorders such as depression.
Highlights
The United States opioid epidemic which was initially driven by prescription opioids has developed into a crisis that envelops heroin as well as illicitly manufactured fentanyl resulting in many deaths and extensive collateral harm to families as well as communities throughout the US [1]
A total of n = 9204 participants were included in the study of which n = 275 had received an opioid prescription in the last 12 months of which n = 54 were diagnosed with prescription opioid use disorder (pOUD)
Conclusions pOUD is a common phenomenon in working-age patients who receive prescription opioid pain therapy in Germany and may be related to the co-existence of psychosomatic and psychiatric disorders such as depression
Summary
The United States opioid epidemic which was initially driven by prescription opioids has developed into a crisis that envelops heroin as well as illicitly manufactured fentanyl resulting in many deaths and extensive collateral harm to families as well as communities throughout the US [1]. Cross-sectional trials in Germany showed that a significant proportion of ambulatory patients with CNCP and long-term opioid therapy (LTOT) were at high risk of opioid misuse (31.5%) or had been diagnosed with prescription opioid use disorder (pOUD) (26.5%), yet both trials lacked in size and generalizability [10, 11]. Data on rates of prescription opioid use disorder (pOUD) in European countries is limited. The aim of this investigation was to analyze a representative population sample regarding the 1-year prevalence of opioid use disorder in patients who received prescription opioid pain therapy and to identify related risk factors
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