title: Quantifying morbidity associated with the abuse and misuse of opioid analgesics: a comparison of two approaches.
abstract: BACKGROUND
  Due to the rising nonmedical use of opioid analgesics, methods are needed to quantify the associated health-related consequences.
  
  
  METHODS
  Using opioid analgesic intentional exposure reports from poison control centers from January 2003-June 2004, we calculated quarterly rates for 7 opioids at the 3-digit ZIP code level using population- and patient-based denominators.
  
  
  RESULTS
  Hydrocodone was the most widely prescribed opioid (maximum: 5,321,390 patients per quarter), with the largest intentional exposure caseload (range: 498-1,290), and the highest aggregate population-based rate (maximum of 13.61 cases per 1,000,000 individuals). Methadone had the highest aggregate patient-based rate (maximum 2.03 cases per 1,000 patients).
  
  
  CONCLUSIONS
  Population- and patient-based rates are complementary tools that address different public health questions. Population-based rates describe the health-related burden of nonmedical opioid analgesic use on the community as a whole, while patient-based rates show this burden ("risk") in relation to the level of corresponding medicinal use ("benefit") within a given area.
authors.affiliation: Purdue Pharma L.P., One Stamford Forum, Stamford, Connecticut 06901-3431, USA. meredith.smith@pharma.com
authors.forename: Meredith Y
authors.initials: MY
authors.lastname: Smith
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.forename: Alicia
authors.initials: A
authors.lastname: Wentz
authors.forename: Alice
authors.initials: A
authors.lastname: Hughes
authors.forename: J David
authors.initials: JD
authors.lastname: Haddox
authors.forename: Richard
authors.initials: R
authors.lastname: Dart
mesh_terms: D000701:Analgesics, Opioid / Q000506:poisoning*; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D009293:Opioid-Related Disorders / Q000401:mortality*; D011039:Poison Control Centers; D015813:Substance Abuse Detection; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D013287:Illicit Drugs