Understanding the Etiology of Prescription Opioid Abuse

Abstract

Although studies on the initiation of substance abuse abound, the body of literature on prescription opioid abuse (POA) etiology is small. Little is known about why and how the onset of POA occurs, especially among high-risk populations. In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously.

Examining the Relationship between Social Context and Prescription Opioid Initiation Routes among Young Adults Entering Medical Detoxification

“…These findings are similar to the larger body of research documenting how often women initiate drugs within social or romantic contexts [7,20,33].…”

“…Similar to other findings of those trying prescription medications for the first time, some of our participants reported misusing their own legitimate prescriptions [5,8,16,20]. Among our sample, young men with sport injuries tended to initiate via oral routes and in isolation; it is likely that peers norms associated with use learned within a social context seem to create a situation by which alternate routes are taught by others.…”

“…Motivations for illicit prescription drug use among young adults [16] and high school student PO misusers [19] have been examined, as well as the onset of PO abuse among drug treatment clients [20] and other populations of substance abusers [21]. Other literature has also documented PO opioid initiation sources among youth and young adult populations of injection drug users [5] however, few studies have explored how social context may influence initiation to PO misuse via alternate routes.…”

Spatial analysis of drug poisoning deaths in the American West, particularly Utah

“…Legitimate prescriptions leading to addiction and then use of illicit drug sources is a pathway that may be more prevalent amongst those experiencing chronic pain (Rigg and Murphy, 2013). …”

Non-medical prescription opioid use predicts injection initiation among street-involved youth

“…After cannabis, youth consistently identify POs as the most commonly misused drug (Johnston, O’Malley, Bachman, & Schulenberg, 2012) and the 2013 US Centre for Disease Control national survey of American high schools found that over 20% of grade 12 students have misused prescription drugs (Kann et al, 2014). In addition to concerns regarding increased risk of morbidity and mortality associated with PO use (Frank et al, 2015, Hall et al, 2008, Office of the National Drug Control Strategy, 2011, Okie, 2010, USCDCP, 2011, USCDCP, 2012, Roy et al, 2004, Silva et al, 2013, Warner et al, 2011 and Zosel et al, 2013), there are also signals from qualitative, retrospective and cross-sectional studies that PO use may facilitate transitions to injection drug use; however, the impact of PO misuse on the incidence of initiation into injecting has not been characterized (Lankenau et al, 2012, Mars et al, 2014, Peavy et al, 2012, Rigg and Murphy, 2013, Young et al, 2012 and Young and Havens, 2012). The objective of this longitudinal study was to examine the relationship between PO misuse and time to injection initiation within an open prospective cohort of street-involved youth in Vancouver, Canada.…”