Risk Factors for Symptoms of Prescription Opioid Misuse: Do Older Adults Differ from Younger Adult Patients?

Cochran, Gerald; Rosen, Daniel; McCarthy, Rebecca; Engel, Rafael J.

doi:10.1080/01634372.2017.1327469

Cited by 30 publications

(22 citation statements)

References 25 publications

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“…In contrast, the two‐thirds of decedents who died of non‐drug‐related causes were an average age of 63 years and more likely to die from chronic health conditions, such as chronic obstructive pulmonary disease, heart disease and dementia. Among older adults, research suggests that substance use disorder is increasing dramatically because of the aging baby‐boomer cohort and that this population has different risk factors for prescription misuse . Although we were unable to identify specific substances (i.e.…”

Section: Discussionmentioning

confidence: 93%

EMS naloxone administration as non‐fatal opioid overdose surveillance: 6‐year outcomes in Marion County, Indiana

et al. 2018

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Background and Aims Despite rising rates of opioid overdose in the United States, few studies have examined the frequency of non-fatal overdose events or mortality outcomes following resuscitation. Given the widespread use of naloxone to respond to overdose-related deaths, naloxone administration may provide a useful marker of overdose events to identify high-risk users at heightened risk of mortality. We used naloxone administration by emergency medical services as a proxy measure of non-fatal overdose to examine repeat events and mortality outcomes during a 6-year period. Methods We conducted a retrospective investigation of all cases in Marion County, Indiana between January 2011 and December 2016 where emergency medical services used naloxone to resuscitate a patient. Cases were linked to vital records to assess mortality and cause of death during the same time-period. We used Cox regression survival analysis to assess whether repeat non-fatal overdose events during the study period were associated with the hazard of mortality, both overall and by cause of death. Results Of 4726 patients administered naloxone, 9.4% (n = 444) died an average of 354 days [standard deviation (SD) = 412.09, range = 1-1980] following resuscitation. Decedents who died of drug-related causes (34.7%, n = 154) were younger and more likely to have had repeat non-fatal overdose events. Patients with repeat non-fatal overdose events (13.4%, n = 632) had a ×2.07 [95% confidence interval (CI) = 1.59, 2.71] higher hazard of all-cause mortality and a ×3.06 (95% CI = 2.13, 4.40) higher hazard of drug-related mortality. Conclusions Among US emergency medical service patients administered naloxone for opioid overdose, those with repeat non-fatal opioid overdose events are at a much higher risk of mortality, particularly drug-related mortality, than those without repeat events.

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Section: Discussionmentioning

confidence: 93%

EMS naloxone administration as non‐fatal opioid overdose surveillance: 6‐year outcomes in Marion County, Indiana

et al. 2018

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“…Studies in patients with chronic pain have also identified associations between misuse of prescribed opioids with male sex, younger age, other drug and alcohol use, nicotine use, legal involvement, depression, and poor psychological functioning. [39][40][41][42][43][44][45][46] Some of these characteristics are used in practice guidelines and checklists to identify patients at "high risk"…”

Section: Discussionmentioning

confidence: 99%

Misuse of prescribed opioids in the United States

Mojtabai

Amin-Esmaeili

Nejat

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To assess the prevalence and correlates of self‐reported misuse of prescribed‐opioid medications in the US general population. Method In 31 068 adult participants of the National Survey on Drug Use and Health (NSDUH) 2015 and 2016 who reported using opioids in the past year, we assessed the prevalence and correlates of self‐reported misuse of prescribed opioids, defined as using a larger dose, more frequently, or longer than prescribed. Multivariable logistic‐regression models and the machine‐learning method of boosted regression were used to identify the correlates of misuse. Results On the basis of weighted NSDUH estimates, of more than 89 million US adults who used prescription opioids every year, close to 3.9 million (4.4%) reported misused the prescribed medications. Prescribed‐opioid misuse was most strongly associated with co‐occurring misuse of opioids without a prescription, misuse of benzodiazepines, other drug‐use disorders, history of illegal activity, and psychological distress. Misuse of prescribed opioids was also strongly associated with prescription opioid–use disorder, especially among those who misused more potent opioids or started misusing opioids before the current year. Conclusions Misuse of prescribed opioids is associated with other high‐risk behaviors and adverse health outcomes. The findings call for better monitoring of opioid prescription in clinical practice.

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“…3,103-111 In particular, the links between major depressive disorder, depressive symptoms and/or suicidality and opioid PDM are robust and well-established in adolescents, 16,41,81,112 young adults 16,113-115 and older adults (50 years and older), 16,94,97,116,117 with a variety of different data sources used. The psychopathology-opioid PDM link may be mediated by race/ethnicity 118 or age, 119 with those 65 and older having weaker psychopathology-opioid PDM associations.…”

Section: Prescription Opioid Misuse Across the Lifespanmentioning

confidence: 99%

Prescription Drug Misuse: Taking a Lifespan Perspective

et al. 2020

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Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the medical or developmental concerns that often underlie PDM, it is likely that PDM varies by age. This review summarizes the literature on PDM across the lifespan, examining lifespan changes in prevalence, sources, motives and correlates for opioid, stimulant, and tranquilizer/sedative (or benzodiazepine) PDM. In all, prevalence rates, sources and motives vary considerably by age group, with fewer age-based differences in correlates or risk factors. PDM prevalence rates tend to decline with aging, with greater use of physician sources and greater endorsement of self-treatment motives in older groups. Recreational motives (such as to get high) tend to peak in young adulthood, with greater use of peer sources or purchases to obtain medication for PDM in younger groups. PDM co-occurs with other substance use and psychopathology, including suicidality, across age groups. The evidence for lifespan variation in PDM is strongest for opioid PDM, with a need for more research on tranquilizer/sedative and stimulant PDM. The current literature is limited by the few studies of lifespan changes in PDM within a single sample, a lack of longitudinal research, little research addressing PDM in the context of polysubstance use, and little research on minority groups, such as sexual and gender minorities.

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Risk Factors for Symptoms of Prescription Opioid Misuse: Do Older Adults Differ from Younger Adult Patients?

Cited by 30 publications

References 25 publications

EMS naloxone administration as non‐fatal opioid overdose surveillance: 6‐year outcomes in Marion County, Indiana

EMS naloxone administration as non‐fatal opioid overdose surveillance: 6‐year outcomes in Marion County, Indiana

Misuse of prescribed opioids in the United States

Prescription Drug Misuse: Taking a Lifespan Perspective

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