title: Sources of prescription opioids among diagnosed opioid abusers.
abstract: OBJECTIVE
  Diversion and abuse of prescription opioids are important public health concerns in the US. This study examined possible sources of prescription opioids among patients diagnosed with opioid abuse.
  
  
  METHODS
  Commercially insured patients aged 12-64 diagnosed with opioid abuse/dependence ('abuse') were identified in OptumHealth Reporting and Insights medical and pharmacy claims data, 2006-2012, and required to have continuous eligibility over an 18 month study period surrounding the first abuse diagnosis. We examined whether abusers had access to prescription opioids through their own prescriptions and/or to diverted prescription opioids through family members' prescriptions obtained prior to the abuser's first abuse diagnosis. For comparison, we examined access to prescription opioids of a reference population of non-abusers. Sensitivity analyses focused on patients initially diagnosed with opioid dependence and, separately, abusers not previously treated with buprenorphine.
  
  
  RESULTS
  Of the 9291 abusers meeting the selection criteria, 79.9% had an opioid prescription prior to their first abuse diagnosis; 20.1% of abusers did not have an opioid prescription prior to their first abuse diagnosis, of whom approximately half (50.8%) had a family member who had an opioid prescription prior to the abuser's first abuse diagnosis (compared to 42.2% of non-abusers). Similar results were found among patients initially diagnosed with opioid dependence and among abusers not previously treated with buprenorphine.
  
  
  CONCLUSIONS
  The study relied on the accuracy of claims data to identify abusers, but opioid abuse is often undiagnosed. In addition, only prescription claims that were reimbursed by a health plan were included in the analysis.
  
  
  CONCLUSIONS
  While most abusers had access to prescription opioids through their own prescriptions, many abusers without their own opioid prescriptions had access to prescription opioids through family members and may have obtained prescription opioids that way. Given the study design and data source, this is likely a conservative estimate of prescription opioid diversion.
authors: Analysis Group Inc. , Boston, MA , USA.
authors: Amie
authors: A
authors: Shei
authors: J Bradford
authors: JB
authors: Rice
authors: Noam Y
authors: NY
authors: Kirson
authors: Katharine
authors: K
authors: Bodnar
authors: Howard G
authors: HG
authors: Birnbaum
authors: Pamela
authors: P
authors: Holly
authors: Rami
authors: R
authors: Ben-Joseph
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002047:Buprenorphine / Q000008:administration & dosage; D002648:Child; D006801:Humans; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: Abuse; Diversion; Opioid analgesics