title: Correlates of Opioid Use in Adults With Self-Reported Drug Use Recruited From Public Safety-Net Primary Care Clinics.
abstract: OBJECTIVE
  The purpose of this study was to compare demographic, clinical, and survival characteristics of drug-using safety-net primary care patients who used or did not use opioids, and to examine treatment implications of our findings.
  
  
  METHODS
  The sample consisted of 868 adults who reported illicit drug use in the 90 days before study enrollment, 396 (45.6%) of whom were opioid users.
  
  
  RESULTS
  Multiple measures indicated that, as a group, opioid users were less physically and psychiatrically healthy than drug users who did not endorse using opioids, and were heavy users of medical services (eg, emergency departments, inpatient hospitals, and outpatient medical) at considerable public expense. After adjusting for age, they were 2.61 (confidence interval, 1.48-4.61) times more likely to die in the 1 to 5 years after study enrollment and more likely to die from accidental poisoning than nonopioid users. Subgroup analyses suggested patients using any nonprescribed opioids had more serious drug problems including more intravenous drug use and greater HIV risk than patients using opioids only as prescribed.
  
  
  CONCLUSIONS
  Use of opioids adds a dimension of severity over and above illicit drug use as it presents in the primary care setting. Opioid users may benefit from psychiatric and addiction care integrated into their primary care setting, naloxone overdose prevention kits, and prevention efforts such as clean needle exchanges. Addiction or primary care providers are in a key position to facilitate change among such patients, especially the third or more opioid users having a goal of abstinence from drugs.
authors.affiliation: Department of Psychiatry and Behavioral Sciences (RR, AK, IIW, KB, DD, CD, PRB), University of Washington at Harborview Medical Center, Seattle, WA; Department of Health Services (CM), University of Washington School of Public Health, Seattle, WA; and Alcohol and Drug Abuse Institute (DD), University of Washington, Seattle, WA.
authors.forename: Richard
authors.initials: R
authors.lastname: Ries
authors.forename: Antoinette
authors.initials: A
authors.lastname: Krupski
authors.forename: Imara I
authors.initials: II
authors.lastname: West
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Kristin
authors.initials: K
authors.lastname: Bumgardner
authors.forename: Dennis
authors.initials: D
authors.lastname: Donovan
authors.forename: Chris
authors.initials: C
authors.lastname: Dunn
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology*; D063487:Prescription Drug Misuse / Q000401:mortality / Q000523:psychology* / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012309:Risk-Taking; D057566:Self Report; D014861:Washington / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid