The association between insomnia and prescription opioid use: results from a community sample in Northeast Florida

Abstract

Objective The current analysis examines whether opioid use is associated with insomnia in a community sample, as the consequences of the growing epidemic of prescription opioid use continue to cause public health concern. Study Design A cross-sectional study including 8,433 members in a community outreach program, HealthStreet, in Northeast Florida. Methods Community Health Workers (CHWs) assessed health information, including use of opioids (i.e., Vicodin®, Oxycodone, Codeine, Demerol®, Morphine, Percocet®, Darvon®, Hydrocodone) from community members during field outreach. Insomnia was determined based on self-report: "Have you ever been told you had, or have you ever had a problem with insomnia?" Summary descriptive statistics were calculated and logistic regression modelling was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals for insomnia, by opioid use status, after adjustment for demographics and other covariates. Results Among 8,433 community members recruited (41% male; 61% black), 2,115 (25%) reported insomnia, and 4,200 (50.3%) reported use of opioids. After adjusting for covariates, opioid users were significantly more likely to report insomnia than non-users (adjusted OR, 1.42; 95% CI, 1.25 –1.61). Conclusion Insomnia was 42% more likely among those who reported using prescription opioids compared to those who did not. With one half of the sample reporting prescription opioid use, and a fourth reporting insomnia it is important to further investigate the relationship between the two. Findings provide useful preliminary information from which to conduct further analyses.

A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida

“…This may be because prescription sedatives are often prescribed as a treatment for many neurological and psychological conditions including anxiety, insomnia, and muscle relaxation ( Griffin, Kaye, Bueno, & Kaye, 2013 ; Moore, Pariente, & Bégaud, 2015 ); prescription opioids are prescribed to treat both chronic and acute pain ( Beaudoin, Lin, Guan, & Merchant, 2014 ; Boudreau et al, 2009 ). Conditions such as anxiety, insomnia, and muscle relaxation commonly co-occur with pain and that may be one possible reason for using sedatives with opioid analgesics ( Holland et al, 1991 ; Serdarevic, Osborne, Striley, & Cottler, 2017 ). Both opioids and sedatives are central nervous system depressants and the combined use of both drugs can result in significant respiratory depression ( Jann, Kennedy, & Lopez, 2014 ) and increase overdose risk ( Dowell, Haegerich, & Chou, 2016 ; Sun et al, 2017 ).…”

Building capacity for collaborative research on opioid and other substance use disorders through the Clinical and Translational Science Award Program

“…The combined capacity of the CTSA Program hubs-infrastructure and expertise-is proving to be ideal for deploying and implementing innovative therapies and tools to address the opioid crisis. Thus, the CTSA Program has produced initial work in pain management and opioid research, including community engagement; however, as the response to this crisis continues, efforts must maximize limited resources and develop a synchronized approach that considers existing strengths and expertise [e.g., medication-assisted treatment (MAT), data science, recruitment and retention, EHR technologies, community, pediatrics] while maintaining each hub's local/regional context [20][21][22]. In this context, the CTSA Program facilitates the development of synergistic collaborations to efficiently test and implement meaningful translational research projects to solve specific problems across the translational spectrum.…”

Differences in Characteristics and Downstream Drug Use Among Opioid‐Naïve and Prior Opioid Users with Low Back Pain

“…Similarly, patients with chronic pain diagnoses receive higher doses of long‐acting opioids on a long‐term basis than those without chronic pain, and rates of opioid dependence have been reported as higher in chronic pain patients as compared to the general population, despite limited efficacy for chronic pain management . Additionally, in a cross‐sectional study of over 8,000 community members, insomnia was 42% more likely among those who reported using prescription opioids compared to those who did not . Sleep quality has also been found to be poorer among opioid‐dependent individuals on methadone maintenance therapy as compared to opioid‐naïve individuals .…”

“…32 Additionally, in a cross-sectional study of over 8,000 community members, insomnia was 42% more likely among those who reported using prescription opioids compared to those who did not. 33 Sleep quality has also been found to be poorer among opioid-dependent individuals on methadone maintenance therapy as compared to opioid-na€ ıve individuals. 34 Interestingly, insomnia and short sleep duration have also been found to be significant risk factors for onset of chronic pain, 35,36 with poor sleep increasing anxiety and hyperalgesia to heat, blunt pressure, cold, and pinprick stimuli.…”