title: Prescription medication misuse among opioid dependent patients seeking inpatient detoxification.
abstract: OBJECTIVE
  Opioid related morbidity and mortality is heightened in context to the concomitant use of psychotropic medications. The aim of this project was to examine the extent to which opioid dependent patients seeking detoxification are using and misusing specific psychotropic agents.
  
  
  METHODS
  As part of a quality assurance/improvement project, we systematically assessed prospectively consecutive admissions to a public detoxification program using a self-report questionnaire to query for specific psychotropic medication use. Patients were asked about having a current prescription, appropriate use, and/or medical misuse (higher doses, using without prescription) of amphetamine salts, clonazepam, clonidine, gabapentin, and pregabalin.
  
  
  RESULTS
  We had data on 196 admissions including 162 patients with opioid dependency. Patients receiving detoxification from opioids compared to alcohol had statistically significant higher rates of medication misuse (30% vs. 0%, respectively; χ(2)  = 12.8, p < .0003). Of opioid dependent patients receiving prescription medication, 28% reported using higher amounts of each medication than prescribed. Of opioid patients, 10% self-reported misusing clonidine, 22% gabapentin, 7% pregabalin, 25% clonazepam, 11% amphetamine salts, and 36% any of these medications.
  
  
  CONCLUSIONS
  Despite the "nonaddictive nature" of some medications (eg, gabapentin, clonidine), high rates of medication misuse in opioid dependent patients admitted for detoxification was found and appeared similar to rates of misuse among controlled substances such as clonazepam and amphetamine salts. These data suggest that opioid dependent patients should be queried for the appropriate use of prescribed medications and that practitioners need to monitor for medication misuse in opioid dependent patients.
authors: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.|Bay Cove Human Services, Andrew House Detoxification Center, Quincy, Massachusetts.
authors: Timothy
authors: T
authors: Wilens
authors: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors: Courtney
authors: C
authors: Zulauf
authors: Bay Cove Human Services, Andrew House Detoxification Center, Quincy, Massachusetts.
authors: Denece
authors: D
authors: Ryland
authors: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors: Nicholas
authors: N
authors: Carrellas
authors: Bay Cove Human Services, Andrew House Detoxification Center, Quincy, Massachusetts.
authors: Isela
authors: I
authors: Catalina-Wellington
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009293:Opioid-Related Disorders / Q000523:psychology*; D055553:Prescription Drugs / Q000627:therapeutic use*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012651:Self Medication; D057566:Self Report; D055815:Young Adult
chemical_list: D055553:Prescription Drugs; D011619:Psychotropic Drugs