Open Access Open Access  Restricted Access Subscription or Fee Access

Associations between public health indicators and injecting prescription opioids by prescription opioid abusers in substance abuse treatment

Ryan A. Black, PhD, Kimberlee J. Trudeau, PhD, Theresa A. Cassidy, MPH, Simon H. Budman, PhD, Stephen F. Butler, PhD

Abstract


Objective: To determine what, if any, public health and societal impacts are associated specifically with injection of prescription opioids. Design: Cross-sectional observational study. Setting: Five hundred forty treatment facilities in 35 states across the United States performing Addiction Severity Index-Multimedia Version (ASI-MV) assessments. Participants: Adult patients (29,459) who reported past 30-day abuse of any prescription opioid on the ASI-MV assessment between January 2007 and January 2011. Main outcome measures: The public health indicators selected for this study were liver disease, HIV/AIDS status, recent visit to an emergency room, treatment for pain, treatment for overdosing, homelessness, residence with alcohol/substance abuser, and unemployment. Results: Prescription opioid injection was significantly associated with health problems, psychosocial problems, and utilization of medical services. Conclusions: This study demonstrates an approach to measure the potential impact of injecting prescription opioids on public health indicators. Findings indicate a positive association between injection of prescription opioids and public health indicators suggesting a need for prescription opioid formulations that may inhibit injection of these medications. Keywords: prescription drug injection, public health, correlates DOI:10.5055/jom.2013.0142

 


Full Text:

PDF

References


Chou R, Fanciullo GJ, Fine PG, et al.: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10: 113-130.

Institute of Medicine of The national Academies: Relieving Pain in America, A blueprint for Transforming Prevention, Care, Education, and Research. 2011. Report Brief, June. Available at

www.iom.edu/relievingpain. Accessed June 29, 2011.

Brennan F, Carr DB, Cousins M, et al.: Pain management: A fundamental human right. Anesth Analg. 2007; 105: 205-221.

Reidenberg MM, Willis O: Prosecution of physicians for prescribing opioids to patients. Clin Pharmacol Ther. 2007; 81(6):903-906.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies: Detailed Tables, 2009 National Survey on Drug Use & Health. 2010. Available at http://oas.samhsa.

gov/WebOnly.htm#NSDUHtabs. Accessed September 2011.

Katz N: Abuse-deterrent opioid formulations: Are they a pipe dream? Curr Rheumatol Rep. 2008; 10(1): 11-18.

Raffa RB, Pergolizzi JV Jr: Opioid formulations designed to resist/deter abuse. Drugs. 2010; 70(13): 1657-1675.

Compton WM, Volkow ND: Abuse of prescription drugs and the risk of addiction. Drug Alcohol Depend. 2006; 83(suppl 1):S4-S7.

National Institute on Drug Abuse: Prescription and over-thecounter medications (NIDA InfoFacts). 2009. Available at http://www.nida.nih.gov/PDF/Infofacts/PainMed09.pdf. Accessed December 2012.

Katz N, Dart RC, Bailey E, et al.: Tampering with prescription opioids: Nature and extent of the problem, health consequences, and solutions. Am J Drug Alcohol Abuse. 2011; 37(4): 205-217.

Sherman SG, Cheng Y, Kral AH, et al.: Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city. Drug Alcohol Depend. 2007; 88(2-3): 182-187.

Milloy MJ, Kerr T, Mathias R, et al.: Non-fatal overdose among a cohort of active injection drug users recruited from a supervised injection facility. Am J Drug Alcohol Abuse. 2008; 34(4): 499-509.

Stoové MA, Dietze PM, Aitken CK, et al.: Mortality among injecting drug users in Melbourne: A 16-year follow-up of the Victorian Injecting Cohort Study (VICS). Drug Alcohol Depend.2008; 96(3): 281-285.

Vlahov D, Wang C, Ompad D, et al.: Collaborative Injection Drug User Study. Mortality risk among recent-onset injection drug users in five U.S. Cities. Subst Use Misuse. 2008; 43(3-4): 413-428.

Disney E, Kidorf M, Kolodner K, et al.: Psychiatric comorbidity is associated with drug use and HIV risk in syringe exchange participants. J Nerv Ment Dis. 2006; 194: 577-583.

Aceijas C, Rhodes T: Global estimates of prevalence of HCV infection among injecting drug users. Int J Drug Policy. 2007; 18(5): 352-358.

Neaigus A, Miller M, Friedman SR, et al.: Potential risk factors for the transition to injecting among non-injecting heroin users: A comparison of former injectors and never injectors. Addiction. 2001; 96: 847-860.

Green TC, Butler SF: A latent class analysis of Rx opioid abuse in the National Addictions Vigilance Intervention & Prevention Program (NAVIPPRO™). San Juan, Puerto Rico: College on Drug Dependence, 2008.

Green TC, Black R, Grimes Serrano JM, et al.: Typologies of prescription opioid use in a large sample of adults assessed for substance abuse treatment. PLoS One. 2011; 6(11): e27244.

Marshall BD, Fairbairn N, Li K, et al.: Physical violence among a prospective cohort of injection drug users: A genderfocused approach. Drug Alcohol Depend. 2008; 97(3): 237-246.

Young AM, Havens JR, Leukefeld CG, et al.: Route of administration for illicit prescription opioids: A comparison of rural and urban drug users. Harm Reduct J. 2010; 7: 24.

Butler SF, Black R, Grimes Serrano JM, et al.: Characteristics of prescription opioid abusers in treatment: Opioid use history, age, use patterns, and functional severity. J Opioid Manag. 2010; 6(4): 230-252.

Butler SF, Budman SH, Licari A, et al.: National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO™): A real-time, product-specific, public health surveillance system for monitoring Rx drug abuse. Pharmacoepidemiol Drug Saf. 2008; 17(12): 1142-1154.

Hendricks VM, Kaplan CD, VanLimbeek J, et al.: The Addiction Severity Index: Reliability and validity in a Dutch addict population. J Subst Abuse Treat. 1989; 6: 133-141.

Kosten TR, Rounsaville BJ, Kleber HD, et al.: Concurrent validity of the Addiction Severity Index. J Nerv Ment Dis. 1983; 171(10): 606-610.

McLellan AT, Luborsky L, Woody GE, et al.: An improved diagnostic evaluation instrument for substance abuse patients. J Nerv Ment Dis. 1980; 168: 26-33.

McLellan AT, Kushner H, Metzger D, et al.: The fifth edition of the Addiction Severity Index. J Subst Abuse Treat. 1992; 9(3): 199-213.

Butler SF, Budman SH, Goldman RJ, et al.: Initial validation of a computer-administered Addiction Severity Index: The ASIMV. Psychol Addict Behav. 2001; 15(1): 4-12.

Butler SF, Redondo JP, Fernandez KC, et al.: Validation of the Spanish Addiction Severity Index Multimedia Version (SASI-MV). Drug Alcohol Depend. 2009; 99(1-3): 18-27.

McGahan PL, Griffith JA, Parente R, et al.: Composite Scores from the Addiction Severity Index. Philadelphia, PA: Department of Veterans Affairs Medical Center, 1986.

Katz NP, Adams EH, Chilcoat H, et al.: Challenges in the development of prescription opioid abuse-deterrent formulations.Clin J Pain. 2007; 8: 648-660.

Kleinbaum DG, Kupper LL, Nizam A, and et al.: Applied Regression Analysis and Other Multivariable Methods. 4th ed. Pacific Grove: Duxbury Press/Cengage Learning, 2008.

Neaigus A, Gyarmathy VA, Miller M, et al.: Injecting and sexual risk correlates of HBV and HCV seroprevalence among new drug injectors. Drug Alcohol Depend. 2007; 89(2-3): 234-243.

Hall AJ, Logan JE, Toblin RL, et al.: Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA. 2008; 300(22): 2613-2620.

US FDA: FDA Approves New Formulation for Oxycontin. April 5, 2010. 2010. Available at www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm207480.htm. Accessed April 5, 2010.

Pain Therapeutics Inc.: FDA Complete Response Letter Received for REMOXY. June 24, 2011. Available at http://www.paintrials.com/publications/PR24June2011CRL.pdf. Accessed June 24, 2011.


Refbacks

  • There are currently no refbacks.