Odds Of Prescription Opioid Use Research Articles

Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019–2020

ObjectivesThis study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy.MethodsThis study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression.ResultsThe prevalence of prescription opioid use increases alongside more ACE exposure. Compared to those with no ACEs, recent mothers with three or more ACEs have a 2.4 greater odds of prescription opioid use during pregnancy (aOR [adjusted odds ratio] = 2.437; 95% CI [confidence interval] = 1.319, 4.503).ConclusionExposure to three or more ACEs are associated with a higherrisk of prescription opioid use during pregnancy. Additional research is needed better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.

Maternal Adverse Childhood Experiences (ACEs) Increase Opioid Use During Pregnancy [ID: 1368263

INTRODUCTION: Adverse childhood experiences (ACEs) are linked with a myriad of adverse health outcomes and problematic health behaviors including depression, tobacco use, alcohol use, and illicit drug use. Although studies have drawn a connection between ACEs and substance use in adulthood, there is limited research on whether ACEs are associated with prescription opioids during pregnancy. The current study examines the relationship between ACEs and prescription opioid use during pregnancy using representative data from live births from two states. METHODS: This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. Multiple logistic regression is used to assess the relationship between ACEs and prescription opioid use during pregnancy. RESULTS: The prevalence of prescription opioid use increases alongside accumulating ACEs. Compared to those with no ACEs, recent mothers with three or more ACEs have approximately a 2.4 greater odds of prescription opioid use during pregnancy (adjusted odds ratio 2.437, 95% CI: 1.319, 4.503). CONCLUSION: Given the potential harms of prescription opioid use during pregnancy, the findings suggest the need for additional research to better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.

Incarceration exposure and prescription opioid use during pregnancy

BackgroundPrior research demonstrates a high prevalence of substance use, including opioid use, among those who have had personal or vicarious contact with the correctional system. Relatedly, alongside patterns of rising opioid use in general, opioid use during pregnancy is becoming a growing public health concern. Still, risk factors for prescription opioid use during pregnancy remain understudied. This study is the first to assess the connection between a women’s personal or vicarious exposure to incarceration in the 12 months prior to birth and patterns of prenatal opioid use. MethodsData are from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2019 (N = 17,551 mothers). Logistic and multinomial logistic regression are used to assess the association between incarceration exposure and patterns of opioid use during pregnancy. ResultsIncarceration-exposed women were more likely to use all eight types of prescription opioids assessed in this study (Hydrocodone, Codeine, Oxycodone, Tramadol, Hydromorphone/Meperidine, Oxymorphone, Morphine, and Fentanyl). After adjustment for control variables, incarceration-exposed women were significantly more likely to report any prescription opioid use during pregnancy (OR = 1.745, 95% CI = 1.194, 2.554). Furthermore, relative to no opioid use, incarceration exposure was also associated with illicit prescription opioid use (RRR = 2.979, 1.533, 5.791). ConclusionsIncarceration exposure in the year prior to birth is associated with higher odds of prescription opioid use. These findings add to the burgeoning literature that details a women’s exposure to incarceration is a risk marker for substance use and engagement in health risk behaviors that can jeopardize maternal and infant wellbeing.

Pain and Prescription Opioid Use Among US Construction Workers: Findings From the 2011‒2018 Medical Expenditure Panel Survey.

Objectives. To examine prescription opioid and nonopioid analgesic use among US construction workers and their associations with pain conditions and sociodemographic factors. Methods. We analyzed data for about 9000 (weighted 11.5 million per year) construction workers who responded to the Medical Expenditure Panel Survey from 2011 to 2018. We applied both descriptive statistics and multiple logistic regression procedures in the analyses. Results. An estimated 1.2 million (10.0%) of construction workers used prescription opioid analgesics annually. The adjusted odds of prescription opioid use were significantly higher for workers suffering from work-related injuries (adjusted odds ratio [AOR] = 3.82; 95% confidence interval [CI] = 2.72, 5.37), non‒work-related injuries (AOR = 3.37; 95% CI = 2.54, 4.46), and musculoskeletal disorders (AOR = 2.31; 95% CI = 1.80, 2.95) after we controlled for potential confounders. Adjusted odds of prescription opioid use were also higher among workers with poorer physical health (AOR = 1.95; 95% CI = 1.42, 2.69) or mental health disorders (AOR = 1.95; 95% CI = 1.41, 2.68). Conclusions. Work- and non‒work-related injuries and musculoskeletal disorders significantly increased prescription opioid use among construction workers. To prevent opioid use disorders, multipronged strategies should be approached. (Am J Public Health. 2022;112(S1):S77-S87. https://doi.org/10.2105/AJPH.2021.306510).

US national trends in prescription opioid use after burn injury, 2007 to 2017

BackgroundOpioid misuse and overdose in the United States remain a public health emergency. Overprescribing has been recognized as a significant contributor to the epidemic. Opioids are the mainstay for pain management after burn; however, to date, no large-scale nationally representative study has evaluated outpatient opioid prescribing practices in this population. MethodsA retrospective study was conducted of patients up to 65 years old with burn injuries between 2007 and 2017 using national commercial insurance data. The primary outcome was initial opioid prescribing after burn injury. Secondary outcomes were total days’ supply, oral daily morphine milligram equivalents, and number of refills. ResultsOf the 140,753 patients with burns, 34,685 (24.6%) received an opioid prescription. The odds of prescription opioid use were lower in 2015, 2016, and 2017 compared with 2007. Interactions with age, severity (P < .0001), and region (P = .003) showed significant variation in rates of decline from 2007 to 2017, with the steepest decline in those aged <20 and in residents of Northeast United States. Prescribing rates remained stable over time among those with more severe burn injuries. The significant decline in daily opioid morphine milligram equivalents after 2013 was paralleled by an increase in days of supply (P values <.005). The odds of refill declined in 2016 and 2017. ConclusionWhile opioid prescribing after burn has declined in the past decade, significant variation remains among regions and age groups, suggesting a need to develop uniform guidelines to improve the quality of opioid prescribing and pain management protocols in burn patients.

Prescription opioid use and associated factors among US construction workers.

Construction workers are among the segments of the US population that were hit hardest by the opioid prescription and overdose deaths in the past decades. Factors that underlie opioid use in construction workers have been compartmentalized and isolated in existing studies of opioid use and opioid overdose, but they ignore the overall context of their use. This study examines prescription opioid use and its association with a variety of occupational and nonoccupational factors in construction workers in the United States. Data from the 2011-2017 Medical Expenditure Panel Survey (n = 7994) were analyzed. The prevalence of prescribed opioid use and the association with occupational and nonoccupational characteristics among construction workers were examined in four multiple logistic regression models. The odds of prescription opioid use for workers with occupational injuries was more than triple that of their noninjured counterparts when demographics and occupational factors were controlled (odds ratio = 3.38, 95% confidence interval: 2.38-4.81). Odds of prescription opioid use were higher in older construction workers, workers who were white, non-Hispanic, working part-time, and in poorer health, while Hispanic workers and those without health insurance were much less likely to report prescription opioid use. Prescription opioid use among construction workers encompasses both occupational and nonoccupational factors. As an insight into opioid use among construction workers becomes clearer, effectively responding to the opioid crisis remains a challenge.

Association between psychotropic drug use and prescription opioid use among older adults

This study investigated the association between psychotropic drug use and prescription opioid use/high dosage opioid use among older adults. A sample of 203,750 older adults enrolled in Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) program during 2017 was evaluated for prescription opioid and psychotropic drug usage. High dosage opioid use was defined as using >90 morphine milligram equivalents (MME)/day for ≥90 consecutive days. Overall, 20.7% of enrollees filled opioid prescriptions, of which 1.4% used them at high dosages. Multivariate logistic regression indicated that the odds of prescription opioid use increased with anxiolytic/sedative/hypnotic use and antidepressant use. Moreover, high dosage opioid use was significantly associated with anxiolytic/sedative/hypnotic use, antidepressant use and other factors including being younger, male, white, and married but living separately, and having multiple opioid prescribers. Clinicians should carefully evaluate opioid use among older patients using anxiolytics or antidepressants to minimize risks for adverse consequences of opioids.

The contribution of obesity to prescription opioid use in the United States.

The prevalence of obesity has grown rapidly over the past several decades and has been accompanied by an increase in the prevalence of chronic pain and prescription opioid use. Obesity, through its association with pain, may represent an important contributor to opioid use. This cross-sectional study investigated the relationship between obesity and prescription opioid use among adults aged 35 to 79 years using data from the National Health and Nutrition Examination Survey (NHANES, 2003-2016). Relative to normal weight, body mass indices in the overweight {odds ratio (OR), 1.11 (confidence interval [CI], 0.88-1.39)}, obese I (OR, 1.26 [CI, 1.01-1.57]), obese II (OR, 1.69 [CI, 1.34-2.12]), and obese III (OR, 2.33 [CI, 1.76-3.08]) categories were associated with elevated odds of prescription opioid use. The association between excess weight and opioid use was stronger for chronic opioid use than for use with a duration of less than 90 days (P-value, <0.001). We estimated that 14% (CI, 9%-19%) of prescription opioid use at the population level was attributable to obesity, suggesting there might have been 1.5 million fewer opioid users per year under the hypothetical scenario where obese individuals were instead nonobese (CI, 0.9-2.0 million users). Back pain, joint pain, and muscle/nerve pain accounted for the largest differences in self-reported reasons for prescription opioid use across obesity status. Although interpretation is limited by the cross-sectional nature of the associations, our findings suggest that the obesity epidemic may be partially responsible for the high prevalence of prescription opioid use in the United States.

Assessing craving and its relationship to subsequent prescription opioid use among treatment-seeking prescription opioid dependent patients

BackgroundCraving is viewed as a core feature of substance use disorders and has been shown to predict future drug use, particularly over the short term. Accordingly, craving is often assessed in treatment settings as a marker of risk for subsequent drug use. The identification of the briefest measure that maintains predictive validity is of particular value for both clinical and research settings to minimize assessment burden while maintaining utility for the prediction of use. MethodsData from a multi-site clinical trial of treatment for prescription opioid dependence were examined to evaluate whether a brief, 3-item craving scale administered each week predicted urine-confirmed self report of prescription opioid use in the subsequent week. Logistic regression models examining the association between craving and presence or absence of opioid use in the following week were conducted, controlling for opioid use in the previous week, treatment condition, and lifetime history of heroin use. ResultsGreater craving was associated with a higher odds of prescription opioid use in the following week. For each one-unit increase on this 10-point scale, the odds of using opioids in the subsequent week was 17% higher. In addition to an item assessing urges, items assessing cue-induced craving and perceived likelihood of relapse in an environment where drugs were previously used contributed uniquely to this association. ConclusionsA brief measure of prescription opioid craving predicted prescription opioid use among individuals in treatment. This measure offers an efficient strategy to inform the assessment of risk for use in this population.