Non-medical use of prescription pain medications and increased emergency department utilization: Results of a national survey
Section snippets
Background
In the past decade, prescribing of opioid medications in the United States has quadrupled (Paulozzi et al., 2011). As the availability of opioid medications has increased so too have rates of opioid-related adverse health outcomes such as opioid overdose and opioid use disorders. Every day, 46 Americans die from an overdose related to prescription opioid medications (Frieden, 2014). In one study, a majority of prescription opioid-related overdose deaths involved the non-medical use of
Data source
We analyzed data from the 2008 through 2013 National Survey of Drug Use and Health (NSDUH) public use files (2009; 2010; 2011; 2012; 2013a; 2014). The NSDUH is an annual cross-sectional survey that provides nationally representative estimates of substance use and other health-related behaviors among members of the non-institutionalized U.S. civilian population aged 12 years or older. The NSDUH sampling frame includes residents of households or non-institutional group quarters, persons without
Results
The study sample consisted of 228,556 adult respondents, representing an estimated 231 million civilian, non-institutionalized adults in the United States. An estimated 10.5 million American adults annually, or 4.6% of the adult population (95% CI 4.4–4.7%), reported past year non-medical use of (NMU) of prescription pain medications. Adults with past year NMU of prescription pain medications were more likely to be young, male, white, publicly insured or uninsured, and unemployed compared with
Discussion
In this study, we examined the association between NMU of prescription pain medications and ED utilization in a nationally representative sample. The 10.5 million U.S. adults with past year NMU of prescription pain medications were significantly more likely to report past year ED utilization. After adjusting for important sociodemographic and clinical factors, we identified an independent association between past year NMU of prescription pain medications and ED utilization. In secondary
Conflicts of interest
No conflict declared.
Sources of funding/support
Dr. Frank was supported by the Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine and the VA Eastern Colorado Health Care System. Dr. Binswanger was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R34DA035952. Dr. Calcaterra was supported by the Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine and by Denver Health Medical Center.
Role of funding sources
The funding organizations had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.
Previous presentations
We presented a preliminary version of these findings as an oral presentation at the Society of General Internal Medicine Meeting on April 23, 2015 in Toronto, Canada.
References (39)
- et al.
Prescription opioid abuse in patients presenting for methadone maintenance treatment
Drug Alcohol Depend.
(2004) - et al.
Prevalence and treatment of pain in EDs in the United States, 2000 to 2010
Am. J. Emerg. Med.
(2014) - et al.
Prescription opioid abuse among enrollees into methadone maintenance treatment
Drug Alcohol Depend.
(2007) - et al.
Nonmedical use of opioid analgesics obtained directly from physicians: prevalence and correlates
Arch. Intern. Med.
(2011) - et al.
Brief Intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial
JAMA Intern. Med.
(2014) - et al.
Emergency department visits involving nonmedical use of selected prescription drugs – United States, 2004–2008
MMWR
(2010) Injury Prevention and Control: Prescription Drug Overdose
(2015)- et al.
The changing face of heroin use in the United States: a retrospective analysis of the past 50 years
JAMA Psychiatry
(2014) - et al.
The dueling obligations of opioid stewardship
Ann. Intern. Med.
(2014) - et al.
Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial
JAMA
(2015)