Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates

Becker, William C.; Tobin, Daniel G.; Fiellin, David A.

doi:10.1001/archinternmed.2011.217

Cited by 40 publications

(31 citation statements)

References 11 publications

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“…Our analyses expand on previous work that examined the correlates of the source of prescription drugs among individuals who used prescription opioids nonmedically (17). For individuals who had used any prescription drug nonmedically -opioids, anxiolytics, or stimulants -we found that correlates of physician source of any prescription drug used nonmedically included characteristics such as older age, having insurance or having prescription drug dependence.…”

Section: Discussionsupporting

confidence: 57%

“…The responses were classified into nine mutually exclusive categories. We categorized the respondents' answers into physician source (a prescription from one doctor or from more than one doctor) versus non-physician source (friend or relative for free; took from a friend or relative without asking; wrote fake prescription; stole from doctor's office, clinic, hospital or pharmacy; bought from drug dealer or other stranger; bought on the internet; or got some other way) (17).…”

Section: Methodsmentioning

confidence: 99%

“…Based on a prior study using the NSDUH that evaluated source of prescription opioids, we included age, gender and licit and illicit substance dependence as correlates (17). We also included covariates such as ethnicity, marital status, income, education, employment status, insurance status, general health status, and psychological distress because of their association with nonmedical use of prescription drugs (32,33).…”

Section: Socio-demographic and Clinical Characteristicsmentioning

confidence: 99%

“…One contributing factor to prescription drug-related overdoses may be how people obtain these drugs, either from a physician or non-physician source. A recent study documented that the majority of people with nonmedical use of prescription drugs acquire these drugs from a non-physician source, such as from family and friends (16), and that factors associated with a physician source of nonmedical opioids use include older age, nonwhite race, and opioid use disorder (17). Given the influence of rural culture on illicit drug use and use of mental health and substance use services, the lower density of physicians in rural areas and differences in healthcare utilization between urban and rural populations, we hypothesized that a greater proportion of rural residents would obtain their prescription drugs for nonmedical use from a non-physician source (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

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Source of prescription drugs used nonmedically in rural and urban populations

Wang

Fiellin

Becker

2014

The American Journal of Drug and Alcohol Abuse

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Section: Discussionsupporting

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Section: Socio-demographic and Clinical Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Source of prescription drugs used nonmedically in rural and urban populations

Wang

Fiellin

Becker

2014

The American Journal of Drug and Alcohol Abuse

Self Cite

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“…[1][2][3][4][5][6][7][8][9][10][11] Greater opioid prescribing contributed to increased opioid availability for abuse and overdose. [12][13][14] Primary care physicians (PCPs) and internists prescribe the majority of opioids. 15,16 PCPs have long-standing patient relationships and know when their patients have substance use disorders or ongoing psychosocial stressors that may increase their risk of opioid misuse.…”

Section: Introductionmentioning

confidence: 99%

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

et al. 2015

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BACKGROUND: Chronic opioid therapy for chronic pain treatment has increased. Hospital physicians, including hospitalists and medical/surgical resident physicians, care for many hospitalized patients, yet little is known about opioid prescribing at hospital discharge and future chronic opioid use. OBJECTIVE: We aimed to characterize opioid prescribing at hospital discharge among 'opioid naïve' patients. Opioid naïve patients had not filled an opioid prescription at an affiliated pharmacy 1 year preceding their hospital discharge. We also set out to quantify the risk of chronic opioid use and opioid refills 1 year post discharge among opioid naïve patients with and without opioid receipt at discharge. DESIGN: This was a retrospective cohort study. PARTICIPANTS: From 1 January 2011 to 31 December 2011, 6,689 opioid naïve patients were discharged from a safety-net hospital. MAIN MEASURE: Chronic opioid use 1 year post discharge. KEY RESULTS: Twenty-five percent of opioid naïve patients (n=1,688) had opioid receipt within 72 hours of discharge. Patients with opioid receipt were more likely to have diagnoses including neoplasm (6.3 % versus 3.5 %, p<0.001), acute pain (2.7 % versus 1.0 %, p<0.001), chronic pain at admission (12.1 % versus 3.3 %, p<0.001) or surgery during their hospitalization (65.1 % versus 18.4 %, p<0.001) compared to patients without opioid receipt. Patients with opioid receipt were less likely to have alcohol use disorders (15.7 % versus 20.7 %, p<0.001) and mental health disorders (23.9 % versus 31.4 %, p<0.001) compared to patients without opioid receipt. Chronic opioid use 1 year post discharge was more common among patients with opioid receipt (4.1 % versus 1.3 %, p<0.0001) compared to patients without opioid receipt. Opioid receipt was associated with increased odds of chronic opioid use (AOR=4.90, 95 % CI 3.22-7.45) and greater subsequent opioid refills (AOR=2.67, 95 % CI 2.29-3.13) 1 year post discharge compared to no opioid receipt. CONCLUSION:Opioid receipt at hospital discharge among opioid naïve patients increased future chronic opioid use. Physicians should inform patients of this risk prior to prescribing opioids at discharge.

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Opioid Analgesic Misuse in a Community-Based Cohort of HIV-Infected Indigent Adults

et al. 2013

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Opioid Analgesic Misuse in a Community-Based Cohort of HIV-Infected Indigent Adults O pioid analgesic misuse has risen in conjunction with increased rates of opioid prescribing. The association may be due to increased misuse among individuals receiving prescribed opioids or among those acquiring diverted opioids. 1 Individuals with pain and co-occurring mental health or substance use disorders are at an increased risk for misuse. 2,3 Despite guidelines recommending caution, 4 health care providers prescribe opioids to individuals with these disorders at higher rates than they do to individuals without them. 5 Few studies have examined misuse among highrisk, community-based populations. We conducted a longitudinal study of a community-sampled cohort of human immunodeficiency (HIV)-infected indigent adults, selected without regard to pain status or receipt of prescribed opioids, to examine rates of and factors associated with opioid analgesic misuse. Methods. We recruited participants from the Research on Access to Care in the Homeless (REACH) study, a longitudinal cohort of indigent HIV-infected adults in San Francisco recruited via community-based probability sampling. 6 We interviewed participants at a communitybased field site quarterly for 2 years about pain, treatment for pain, alcohol use, current smoking, illicit substance use, and depression. We described methods and study variables previously. 7,8 At each interview, participants self-reported opioid analgesic misuse behaviors using audio computer assisted self-interviewing (ACASI) technology. We asked participants to report whether their motivation for misuse was to "treat pain," "get high," both, or neither. We defined major opioid analgesic misuse as behaviors that posed imminent risk for overdose or legal peril, or behaviors for which more than 50% of the participants reported their motivation for the behavior was to get high (Table). We reported past 90day rates of misuse at the enrollment interview and cumulative rates over the study interval. Using mixedeffects multivariate logistic regression, we determined factors associated with major misuse.

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Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates

Cited by 40 publications

References 11 publications

Source of prescription drugs used nonmedically in rural and urban populations

Source of prescription drugs used nonmedically in rural and urban populations

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

Opioid Analgesic Misuse in a Community-Based Cohort of HIV-Infected Indigent Adults

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