Nonmedical Use Of Prescription Pain Relievers Research Articles

Untreated depression and non-medical use of prescription pain relievers: findings from the National Survey on Drug Use and Health 2008-2014

ABSTRACTObjectives: Despite growing concerns for non-medical use of prescription pain relievers (NMUPPRs), little is known about the role of comorbid, untreated depressive disorders.Methods: We examined past year rates of NMUPPRs and major depressive episode (MDE), using data between 2008 and 2014 from the National Survey on Drug Use and Health for both youths (12–17 years) and adults (18 or older). Prevalence estimates with 95% confidence intervals were computed. Stratified analyses and generalized linear models were run to examine the association between NMUPPRs and MDE, controlling for treatments received for mental health and/or substance misuse. In order to explore whether MDE effect might change by treatment received, a model with an interaction term including MDE and treatment was fit.Results: Among respondents, about 9% (youths) and 7% (adults) reported past year MDE and about 6% (youths), and 4% (adults) NMUPPRs. About 1.2% (youths) and 0.7% (adults) reported both MDE and NMUPPRs. Those with past year MDE were more likely to report NMUPPRs (RR, 95%CI: 2.60, 2.42–2.80, and 2.64, 2.47–2.82, for youths and adults). Considering the any treatment/MDE interaction on NMUPPRs, MDE risk ratio for subjects who received some treatment (youths: adjusted risk ratio (ARR) = 1.15; adults: ARR = 1.25) was about 70–80% as compared with their untreated counterpart (youths: ARR = 1.57; adults: ARR = 1.54). The likelihood of reporting NMUPPRs amongst respondents who did not receive any treatment was higher for those with past year MDE (main effect: youths ARR = 1.57, p < 0.001; adults ARR = 1.54, p < 0.001).Conclusion: Unrecognized and untreated depressive disorders should be considered for prevention, treatment, and policy implications in order to tackle NMUPPRs epidemic.

Nonmedical prescription pain reliever and alcohol consumption among cannabis users

BackgroundThis study examined poly-drug use involving the use of cannabis with nonmedical prescription pain reliever use (NMPR) and alcohol use. MethodsComputer-assisted survey data from the National Survey on Drug Use and Health were examined. The NSDUH is an annual, cross-sectional survey of non-institutionalized citizens in the United States (ages 12+). Replicate analyses were conducted using the 2013 and 2003 survey waves. ResultsHigher levels of cannabis use were consistently associated with more frequent consumption of prescription pain relievers, with findings replicating in both 2013 and 2003. While the prevalence of dual users declined from 2003 (2.5%) to 2013 (2.3%), the average number of days used among dual users increased by an average of 20 days over that period. These changes largely occurred among those aged 35 or older, males, whites, and non-illicit drug users. Past-year marijuana use increased by 16% (10.8–12.6%, p-value<.001) whereas NMPR decreased by 15% (4.9–4.2%, p-value<.001). The largest changes occurred after 2011. Persons using the most cannabis generally had higher levels of alcohol use relative to those using the least amount of cannabis. There was a significant increase in the prevalence of dual use between 2003 (10.2%) and 2013 (11.6%), while the prevalence of past-year alcohol use remained relatively stable. ConclusionsClinical efforts and public health interventions should consider the possible co-ingestion of cannabis with NMPR and alcohol, as concomitant use may portend negative health effects in the short and long-term.

Non-medical use of prescription pain relievers among high school students in China: a multilevel analysis

ObjectivesGiven the differences between general high school (GHS) and vocational high school (VHS) students, this study aimed to investigate the lifetime prevalence of non-medical use of prescription pain relievers (NMUPPR)...

Industry and Occupation Variations in Nonmedical Prescription Pain Reliever Use

Nonmedical use of prescription pain relievers can be a serious problem for employers. Despite growing attention to prescription drug abuse, little is known about which industries or occupations are at the highest risk for misuse. This study used data from the National Survey on Drug Use and Health to compare each industry to every other industry to identify significant differences in rates of past-year prescription drug misuse. Findings suggest that for industries with the highest prevalence rates, prescription misuse cannot be explained by basic demographics and likely involves elements inherent to the work context and requirements.

Utility of Oral Fluid in Compliance Monitoring of Opioid Medications

Background: Prescription drug abuse is the fastest growing drug problem in the United States, and the increase in unintentional drug overdose deaths has been driven by the increase in opioid analgesic use. Given the epidemic of non-medical prescription pain reliever use and the current medico-legal climate, it is increasingly important for the prescriber to monitor for medication compliance. Objectives: The purpose of this IRB approved study is to compare the results of oral fluid (OF) and routine urinalysis for monitoring compliance in a single academic pain management program in an urban setting in order to evaluate the utility of OF analysis in compliance monitoring when prescribing opioid medications. Study Design: Outcomes analysis of prospective, consecutive, paired comparison study with clinical implications. Setting: Single academic interventional pain management center in the United States. Methods: Paired OF and urine specimens were collected for each patient with signed informed consent, at the Institute for Pain Medicine, Western Pennsylvania Hospital, from patients who routinely donated urine on a random basis for compliance testing. A total of 153 paired specimens were analyzed. Demographic and prescription data were made available. Specimens were screened using immunoassay and presumptive positive findings were confirmed with liquid-chromatography and mass spectrometry. Although both matrices were tested for a wider range of medications, the data presented here are representative of analgesic opioids and benzodiazepine drug classes only. Results: Following exclusion criteria, of the 132 remaining specimen pairs that were positive for opioids or benzodiazepines in at least one matrix, 101 pairs showed exact drug class matches (76.5%). In an additional 21 pairs, at least one drug class was positive in both matrices (15.9%), giving an overall agreement of 92.4%. Overall, 191 positive results were found in urine averaging 1.4 drugs per specimen; 176 positives were detected using OF for an average of 1.3 drugs per specimen. Conclusions: In the setting of stable dosing of prescription opioids and/or concomitant illicit drug use, given comparable detection rates between urine and OF matrix qualitative results, the OF matrix for drug testing for compliance monitoring may serve as a useful and valid testing tool. The authors conclude that overall OF analysis produces comparable results to urine sample analysis with detection rates differing primarily due to differences in windows of detection for different drug classes. Limitations: The limitations include the study was performed in a single academic center in an urban community. Also, there is a paucity of literature regarding windows of detection for OF analysis compared to urine. IRB: APPROVED - Allegheny-Singer Research Institute West Penn Allegheny Heath System (ASRIWPAHS) - IRB Study #FWA00015120 Key Words: Urine drug testing, oral fluid drug testing, saliva, opioids, drug abuse, compliance, chronic pain, diversion

Discrepancies in prevalence estimates in two national surveys for nonmedical use of a specific opioid product versus any prescription pain reliever

BackgroundThere is a growing need to understand trends in nonmedical use of prescription pain relievers as a class, as well as specific opioid products. Surveys such as monitoring the future (MTF) and the National Survey on Drug Use and Health (NSDUH) are important tools for understanding trends in abuse of prescription and illegal drugs. This report compares discrepancies in prevalence between these surveys for a specific opioid product (oxycodone) relative to other drugs. MethodsTrends in past-year use of marijuana, cocaine, and nonmedical use of oxycodone and any prescription pain reliever were estimated for each survey for a five year period (2005–2010) for adolescents in 12th grade. The proportion of nonmedical pain reliever users who abused oxycodone was estimated for each survey. ResultsPrevalence of past-year oxycodone nonmedical use was steady over time for both surveys, but 2.5–3 times higher in the MTF compared to the NSDUH. Trends in prevalence of marijuana and cocaine use were similar across surveys, although prevalence estimates for each were on average 18% higher in the MTF. In contrast, prevalence estimates for any nonmedical prescription pain reliever use were on average 15% lower in MTF. The proportion of nonmedical prescription pain reliever users who used oxycodone was 42% in the MTF versus 19% in the NSDUH. ConclusionThe discrepancy between surveys in prevalence estimates for nonmedical use of oxycodone exceed those for other drugs, pointing to the importance of visual aids and items used to measure the nonmedical use of specific products.

Nonmedical prescription pain reliever use by levels of pain interference: findings from a nationally representative cohort study

Nonmedical prescription pain reliever use by levels of pain interference: findings from a nationally representative cohort study