title: Prescription opioid use among addictions treatment patients: nonmedical use for pain relief vs. other forms of nonmedical use.
abstract: BACKGROUND
  Differences between those who engage in nonmedical prescription opioid use for reasons other than pain relief and those who engage in nonmedical use for reasons related to pain only are not well understood.
  
  
  METHODS
  Adults in a residential treatment program participated in a cross-sectional self-report survey. Participants reported whether they used opioids for reasons other than pain relief (e.g., help sleep, improve mood, or relieve stress). Within those with past-month nonmedical opioid use (n=238), logistic regression tested differences between those who reported use for reasons other than pain relief and those who did not.
  
  
  RESULTS
  Nonmedical use of opioids for reasons other than pain relief was more common (66%) than nonmedical use for pain relief only (34%), and those who used for reasons other than pain relief were more likely to report heavy use (43% vs. 11%). Nonmedical use for reasons other than pain relief was associated with having a prior overdose (odds ratio [OR]=2.54, 95% CI: 1.36-4.74) and use of heroin (OR=4.08, 95% CI: 1.89-8.79), barbiturates (OR=6.44, 95% CI: 1.47, 28.11), and other sedatives (OR=5.80, 95% CI: 2.61, 12.87). Individuals who reported nonmedical use for reasons other than pain relief had greater depressive symptoms (13.1 vs. 10.5) and greater pain medication expectancies across all three domains (pleasure/social enhancement, pain reduction, negative experience reduction).
  
  
  CONCLUSIONS
  Among patients in addictions treatment, individuals who report nonmedical use of prescription opioids for reasons other than pain relief represent an important clinical sub-group with greater substance use severity and poorer mental health functioning.
authors.affiliation: VA National Serious Mental Illness Treatment Resource and Evaluation Center and VA Health Services Research and Development, North Campus Research Complex, 2800 Plymouth Road, Building 14, Ann Arbor, MI 48109, USA. mybohne@med.umich.edu
authors.forename: Amy S B
authors.initials: AS
authors.lastname: Bohnert
authors.forename: Anna
authors.initials: A
authors.lastname: Eisenberg
authors.forename: Lauren
authors.initials: L
authors.lastname: Whiteside
authors.forename: Amanda
authors.initials: A
authors.lastname: Price
authors.forename: Sean Esteban
authors.initials: SE
authors.lastname: McCabe
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D056687:Off-Label Use; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D063487:Prescription Drug Misuse; D055553:Prescription Drugs / Q000627:therapeutic use*; D012114:Residential Treatment; D019966:Substance-Related Disorders / Q000534:rehabilitation*
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs