Source of prescription drugs used nonmedically in rural and urban populations.
BACKGROUND
Unintentional overdose deaths due to nonmedical use of prescription drugs disproportionately impact rural over urban settings in the United States. Sources of these prescriptions may play a factor.


OBJECTIVE
This study examines the relationships between rurality and source of prescription drugs used nonmedically.


METHODS
Using data from the National Survey on Drug Use and Health 2008-2010 (n = 10 693), we examined bivariate and multivariate associations of socio-demographic and clinical correlates and source (physician or non-physician) of prescription drugs (opioid, sedative, tranquilizer, or stimulant) used nonmedically among urban and rural residents. We also examined the type of prescription drugs used nonmedically among urban and rural residents by source.


RESULTS
Among respondents reporting past year nonmedical use of prescription medications, 18.9% of urban residents and 17.5% of rural residents had a physician source for drugs used nonmedically. Likelihood of physician source for urban and rural residents was increased in Hispanic, insured individuals and those with any prescription drug dependence. Rural residents who had a non-physician source were more likely than urban residents with a non-physician source to use hydrocodone (49% vs. 43.3%, p = 0.05), morphine (17.7% vs. 14.0%, p = 0.04), tramadol products (18.1% vs. 11.2%, p = 0.003), and methadone (17.2% vs. 10.9%, p = 0.001).


CONCLUSIONS
Urban and rural individuals with nonmedical use of prescription drugs are equally likely to obtain these prescriptions from a physician source. Some factors associated with obtaining prescription drugs from a physician source differed between these populations, which may have implications for public health approaches to addressing problems such as overdose.
Department of Medicine, The Veterans Affairs Connecticut Healthcare System , West Haven, CT, USA .
Karen H
KH
Wang
David A
DA
Fiellin
William C
WC
Becker
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D063487:Prescription Drug Misuse; D012424:Rural Population; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders; D014481:United States; D014505:Urban Population; D055815:Young Adult
Drug diversion; nonmedical use; prescription drugs; rural health; substance-related disorder