Prescription medication exchange patterns among methadone maintenance patients

Abstract

BACKGROUND Exchange of prescription medications is a significant public health problem particularly among substance abusing populations. Little is known about the extent of medication sharing and receiving behaviors in methadone maintenance treatment (MMT) populations and the factors associated with such behaviors. METHODS We examined rates, and factors associated with past year medication sharing and receiving practices of 315 MMT smokers who had enrolled in a clinical trial of smoking cessation. Sequential logistic regression models estimated the effect of demographic and substance use variables on the probability of sharing or receiving medications. RESULTS Participants averaged 40 years of age, and 49% were male. Among persons prescribed medications, 19.9% reported sharing. Nearly 40% had used medication not prescribed to them. Pain medications, sleep medications, and sedatives, were most commonly shared and received. Younger age was a significant predictor of both sharing medications (OR = 0.92, 95%CI 0.88; 0.96, p < .01) and receiving medications (OR = 0.94; 95%CI 0.92, 0.97, p < .01). Financial hardship (OR = 2.05; 95%CI 1.13; 3.72, p < .05), and recent use of heroin (OR = 5.59, 95%CI 1.89; 16.57, p < .01) or cocaine (OR = 3.70, 95%CI 1.48; 9.28, p < .05), were also independently associated with a significantly higher likelihood of receiving prescription drugs of abuse. CONCLUSIONS The high prevalence of prescription medication sharing and receiving behaviors among persons in MMT often include substances with abuse potential and suggest the need for comprehensive approaches for minimizing this phenomenon.

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

“…It was mentioned that especially younger people become inclined to indiscriminate use of OTC analgesics and that OTC analgesics, such as those in the form of effervescent tablets, are seen as harmless. This observation is consistent with the results of several studies that have found that younger people are more inclined to share medications than older ones 1,5,21. However, Goldsworthy et al did not find a correlation between age and lending medication 8…”

“…It is already known that a problem with addiction increases the risk for the borrowing of prescription medications 14,21…”

A Review of Buprenorphine Diversion and Misuse

“…The most commonly shared drug classes were allergy medications (25%), pain relievers (22%) and antibiotics (21%). Similar to these community dwelling sample surveys (i.e., having a substance use disorder was not required for inclusion), surveys of patients enrolled in outpatient opioid agonist programs (methadone or buprenorphine) across distinct geographical regions with widely varying treatment structures report that 18-28% have sold, given away their medication, removed it while under supervision, or shared other prescribed medication [Germany 23% (Stover, 2011); Australia 28% (Larance et al, 2011a); U.S., 18% (Caviness et al, 2013)]. Thus, sharing and receiving prescribed medications (i.e., diversion) is not unique to those with drug dependence disorders and a variety of medication, not only those with abuse liability, is diverted.…”

Psychoactive medications and disengagement from office based opioid treatment (obot) with buprenorphine

“…In a recent review of the rising national prevalence of psychoactive polypharmacy among outpatient psychiatrists, other researchers note that many of these medication combinations are not evidence-based and come with increased risk and unknown clinical benefit (Mojtabai and Olfson, 2010). In patients with OUD, potential additional risks of polypharmacy exist such as de-stabilization of OUD recovery (Caviness et al, 2013; Heikman et al, 2016; Wilens et al, 2015). However, these risks must be balanced with the need to manage patients’ mood, sleep and pain symptoms to continue to keep them engaged in buprenorphine treatment.…”