title: Prescription opioid use among patients seeking treatment for opioid dependence.
abstract: OBJECTIVE
  This study was designed to assess non-medical prescription opioid use among a sample of opioid dependent participants.
  
  
  METHODS
  A cross-sectional survey was conducted with a convenience sample of patients hospitalized for medical management of opioid withdrawal. We collected data related to participant demographics, socio-economic characteristics, the age of first opioid use, types of opioids preferred, and routes of administration. We also asked participants to describe how they first began using opioids and how their use progressed over time.
  
  
  RESULTS
  Among the 75 participants, the mean age was 32 years (SD: +/- 11, range: 18-70), 49 (65%) were men, 58 (77%) considered themselves to be "white," 55 (74%) had a high school diploma or equivalent, and 39 (52%) were unemployed. All of these participants considered themselves to be "addicted." Thirty-one (41%) felt that their addiction began with "legitimate prescriptions," 24 (32%) with diverted prescription medications, and 20 (27%) with "street drugs" from illicit sources; however, 69 (92%) had reported purchasing opioids "off the street" at some point in time. Thirty-seven (49%) considered heroin to be their current preferred drug, and 43 (57%) had used drugs intravenously.
  
  
  CONCLUSIONS
  We found that many treatment-seeking opioid dependent patients first began using licit prescription drugs before obtaining opioids from illicit sources. Later, they purchased heroin, which they would come to prefer because it was less expensive and more effective than prescription drugs.
authors.affiliation: Department of Family Medicine, State University of New York, University of Buffalo, Family Medicine Research Institute, SUNY Clinical Center, Buffalo, NY 14215, USA.
authors.forename: Marta C
authors.initials: MC
authors.lastname: Canfield
authors.forename: Craig E
authors.initials: CE
authors.lastname: Keller
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Frydrych
authors.forename: Lisham
authors.initials: L
authors.lastname: Ashrafioun
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Purdy
authors.forename: Richard D
authors.initials: RD
authors.lastname: Blondell