Quantifying morbidity associated with the abuse and misuse of opioid analgesics: a comparison of two approaches.
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.
Smith
Meredith Y
MY
Purdue Pharma L.P., One Stamford Forum, Stamford, Connecticut 06901-3431, USA. meredith.smith@pharma.com
Schneider
Michael F
MF
Wentz
Alicia
A
Hughes
Alice
A
Haddox
J David
JD
Dart
Richard
R
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
D000701:Analgesics, Opioid; D013287:Illicit Drugs