Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates.
BACKGROUND
Non-medical use of prescription opioids carries risks including development of abuse/dependence. Such use may correlate with psychiatric, medical, and substance use characteristics.


METHODS
Cross-sectional survey, the 2002-2004 National Survey on Drug Use and Health. Respondents 18 years and older (n=91,823). Bivariate and multivariable associations were investigated.


RESULTS
The prevalence of past-year non-medical use of prescription opioids was 4.5%. Of those with non-medical use, 12.9% met criteria for abuse/dependence. On multivariable analysis, past-year non-medical use was associated with panic (AOR 1.2; 95% CI 1.04-1.5), depressive (AOR 1.2; 95% CI 1.01-1.5) and social phobic/agoraphobic symptoms (AOR 1.2; 95% CI 1.1-1.4). Among those with past-year non-medical prescription opioid use, those with abuse/dependence were more likely to have panic (AOR 1.7; 95% CI 1.2-2.4) and social phobic/agoraphobic symptoms (AOR 1.7; 95% CI 1.2-2.4). In addition, they were more likely to report fair/poor health (AOR 2.1; 95% CI 1.4-3.0), have misused another class of prescription medication (AOR 1.7; 95% CI 1.2-2.3), have used heroin (AOR 2.9; 95% CI 1.2-6.9) and initiated substance use before the age of 13 (AOR 4.7; 95% CI 1.1-19.9).


CONCLUSIONS
Non-medical use of prescription opioids is common. Furthermore, nearly 13% of those with non-medical use meet criteria for abuse/dependence. Panic, social phobia and agoraphobia, low self-rated health status, and other substance misuse among those with non-medical use of prescription opioids should alert clinicians to screen for abuse and dependence.
Becker
William C
WC
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, United States. wbecke01@hotmail.com
Sullivan
Lynn E
LE
Tetrault
Jeanette M
JM
Desai
Rani A
RA
Fiellin
David A
DA
D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000428:Alcohol Drinking / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology