title: Illicit Substance Use in US Adults With Chronic Low Back Pain.
abstract: METHODS
  A population-based cross-sectional survey.
  
  
  OBJECTIVE
  The aim of this study was to compare the prevalence of illicit drug use among US adults with and without chronic low back pain (cLBP).
  
  
  BACKGROUND
  Although addictive medications, such as opioids and benzodiazepines, are frequently prescribed to patients with cLBP, little is known about illicit drug use among Americans with cLBP.
  
  
  METHODS
  We used data from the back pain survey, administered to a representative sample of US adults aged 20 to 69 years (N = 5103) during the 2009 to 2010 cycle of the National Health and Nutrition Examination Survey (NHANES). Participants with pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold for at least 3 months were classified as having cLBP (N = 700). The drug use questionnaire was self-administered in a private setting, and included data on lifetime and current use of marijuana or hashish, cocaine, heroin, and methamphetamine. Chi-square tests, one-way analysis of variance, and logistic regression, adjusted for age, gender, race, and level of education, were used for comparisons.
  
  
  RESULTS
  About 46.5% of US adults with cLBP used marijuana versus 42% of those without cLBP [Adjusted odds ratio (aOR) 1.36, 95% confidence interval (95% CI) 1.06-1.74]. About 22% versus 14% used cocaine (aOR 1.80, 95% CI 1.45-2.24), 9% versus 5% used methamphetamine (aOR 2.03, 95% CI 1.30-3.16), and 5% versus 2% used heroin (aOR 2.43, 95% CI 1.44-4.11). Subjects with cLBP who reported lifetime illicit drug use were more likely to have an active prescription for opioid analgesics than those without illicit drug use history: 22.5% versus 15.3%, P = 0.018.
  
  
  CONCLUSIONS
  cLBP in community-based US adults was associated with higher odds of using marijuana, cocaine, heroin, and methamphetamine. Prescription opioid analgesic use was more common in cLBP sufferers with a history of illicit drug use.
  
  
  METHODS
  2.
authors.affiliation: Division of Rheumatic and Autoimmune Diseases, University of Minnesota, Minneapolis, MN.
authors.forename: Anna
authors.initials: A
authors.lastname: Shmagel
authors.affiliation: Core Investigator at the Minneapolis VA Center for Chronic Disease Outcomes Research, and an Associate Professor of Medicine at the University of Minnesota, Minneapolis, MN.
authors.forename: Erin
authors.initials: E
authors.lastname: Krebs
authors.affiliation: Professor of Medicine and Epidemiology & Community Health at the University of Minnesota, and a Core Investigator at the Minneapolis VA Center for Chronic Disease Outcomes Research, Minneapolis, MN.
authors.forename: Kristine
authors.initials: K
authors.lastname: Ensrud
authors.affiliation: Associate Professor of Medicine at the University of Minnesota, in the Division of Renal Diseases and Hypertension, Minneapolis, MN.
authors.forename: Robert
authors.initials: R
authors.lastname: Foley
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009293:Opioid-Related Disorders; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid