Prescription opioid abuse among drug-involved street-based sex workers

2006 ◽  
Vol 2 (5) ◽  
pp. 283 ◽  
Author(s):  
Hilary L. Surratt, PhD ◽  
James A. Inciardi, PhD ◽  
Steven P.q Kurtz, PhD
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Sex Workers ◽  
Opioid Abuse ◽  
Prescription Drug Abuse ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Hiv Intervention ◽  
The Past ◽  
Prescription Opioid Abuse

National population surveys and individual studies over the past decade have documented the escalating abuse of a variety of prescription medications, particularly prescription opioids. Although surveillance data provide important information for estimating the prevalence of prescription opioid abuse in the general population, studies documenting the patterns of prescription drug abuse among chronic street-drug-using populations are extremely rare. This paper examines the abuse of prescription opioids among drug-involved street-based sex workers in Miami, Florida. The data for this study were drawn from an ongoing HIV intervention trial initiated in 2001, designed to test the relative effectiveness of two alternative HIV prevention protocols for this population. Participants in the study were recruited through traditional targeted sampling strategies, and complete data are available on 588 street-based sex workers. In terms of prescription drug abuse, 12.2 percent of the sample reported using at least one opioid analgesic in the past 90 days without having a legitimate prescription. Logistic regression analyses were conducted to examine the associations between prescription opioid abuse and its predictors. In the multivariate model, factors positively associated with prescription opioid abuse included: Caucasian race (OR = 2.53; 95 percent CI 1.30 to 4.91), current powder cocaine use (OR = 2.28; 95 percent CI 1.28 to 4.08), current heroin use (OR = 2.08; 95 percent CI 1.10 to 3.92), 90-day physical abuse/victimization (OR = 2.07; 95 percent CI 1.18 to 3.61), and shorter sex-work involvement (OR = 1.98; 95 percent CI 1.13 to 3.48). In contrast, daily crack smoking was negatively associated with prescription opioid abuse (OR = 0.61; 95 percent CI 0.33 to 1.10). This study provides some of the first empirical evidence to indicate that prescription opioid abuse is emerging in a heretofore unstudied community of marginalized drug-using sex workers. In addition, data on this population’s mechanisms of access to prescription opioids clearly suggest that there is an active black market for these drugs. These findings warrant intensive study to determine the relative contribution of each mechanism of diversion to the illicit market.

scholarly journals Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

2009 ◽  
Vol 3 ◽  
pp. SART.S2345 ◽  
Author(s):  
Richard M. Reisman ◽  
Pareen J. Shenoy ◽  
Adam J. Atherly ◽  
Christopher R. Flowers
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Control Group ◽  
Prescription Opioids ◽  
Data Set ◽  
Prescription Opioid Abuse

Context The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs) on prescription opioid abuse admissions. Design and Setting A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database) and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set) in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group) for the period 1997–2003. Results From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001). PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063). A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785). Conclusions PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

A Review on Prescription Drug Monitoring Program

2021 ◽  
pp. 265-268
Author(s):  
Someshwar D. Mankar ◽  
Abhijit S. Navale ◽  
Suraj R. Kadam
Keyword(s):  
Systematic Review ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Prescription Drug Monitoring Program ◽  
Prescription Opioid Abuse

Nowadays Prescription Opioid Abuse has become a serious problem, to monitor and reduce Opioid Abuse most of countries developed Prescription Drug Monitoring Program (PDMP). Regarding to this we conduct a systematic review to understanding the PDMP impact in order to reduce Opioid Abuse and improving prescriber practices. This review can help to guide efforts to better response to the Opioid crises.

How Predictors of Prescription Drug Abuse Vary by Age

2008 ◽  
Vol 38 (4) ◽  
pp. 1027-1043 ◽  
Author(s):  
Jeremy Arkes ◽  
Martin Y. Iguchi
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Age Groups ◽  
Prescription Drug Abuse ◽  
Drug Abusers ◽  
Age Group ◽  
The Past ◽  
Nonmedical Use ◽  
Race Ethnicity

Previous studies that have identified the predictors of prescription drug abuse have either focused on a specific age group or pooled all age groups together into one sample. This approach constrains the predictors to have the same effect across age groups. In this study, we use the 2001 to 2003 National Survey on Drug Use and Health to estimate separate models across five age groups for the past year nonmedical use of prescription drugs. The results indicate that several factors (e.g., gender, race/ethnicity marital status, other substance use) have quite different correlations with prescription drug abuse across age groups. This suggests that more accurate profiles of prescription drug abusers can be obtained by estimating separate models for different age groups.

Use and misuse of buprenorphine in the management of opioid addiction

2007 ◽  
Vol 3 (6) ◽  
pp. 302 ◽  
Author(s):  
Theodore J. Cicero, PhD ◽  
Hilary L. Surratt, PhD ◽  
James Inciardi, PhD
Keyword(s):  
Total Sample ◽  
Opioid Abuse ◽  
Treatment Programs ◽  
Prescription Opioid ◽  
High Risk Population ◽  
Drug Abuse Treatment ◽  
The Past ◽  
Abuse Treatment ◽  
Number Of Individuals ◽  
Prescription Opioid Abuse

Buprenorphine was approved in late 2004 for the treatment of opioid abuse and dependence in specially trained and certified physicians’ offices. At the time of the approval, there was a regulatory concern that given the anticipated wide exposure there would be unexpectedly high levels of abuse in the high-risk population for which it was intended. To assess its abuse potential, the authors recruited more than 1,000 individuals seeking treatment for prescription opioid abuse from 100 stand-alone (ie, self-pay or insurance) drug abuse treatment programs around the country to determine whether they misused buprenorphine in the past 30 days to get high. The results indicate that there was a time-related increase in the number of subjects who used burprenorphine to get high, reaching 30-35 percent of individuals completing a questionnaire in the second quarter of 2006. At this time, it was equivalent to the misuse of methadone, both of which, however, were considerably lower than hydrocodone and oxycodone. Thereafter, the number of individuals using buprenorphine to get high dropped in a near linear fashion to less than 20 percent of those completing a questionnaire in the second quarter of 2007, significantly lower than that for methadone, oxycodone, and hydrocodone. The most likely interpretation of these data is that the polysubstance- abusing population, for whom buprenorphine is intended, experimented with this medication for its mood-altering effects for a period of time, but presumably because of its lack of euphorogenic properties, its use has now dissipated. Additionally, support for this conclusion is the very rare endorsement of buprenorphine as a primary drug (<3 percent of the total sample). Thus, the results indicate that it is unlikely that buprenorphine abuse will ever reach the epidemic that was feared by some regulatory groups and that its use in opioid detoxification and maintenance should continue.

Physicians' Role in Curbing the Worst Drug Crisis in America: Prescription Opioid Abuse

2018 ◽  
Author(s):  
Sairam Atluri ◽  
Gururau Sudarshan
Keyword(s):  
Chronic Pain ◽  
Opioid Abuse ◽  
Screening Tools ◽  
Prescription Drug Abuse ◽  
Prescription Opioid ◽  
Dose Limitation ◽  
Chronic Pain Patients ◽  
Urine Drug ◽  
Pain Patients ◽  
Prescription Opioid Abuse

Opioids have an important role in the management of acute, cancer, and chronic pain. However, their indiscriminate use in chronic pain has led, in part, to the epidemic of prescription drug abuse, resulting in a dramatic increase in morbidity and mortality in America. Most of this abuse originates from legitimate prescriptions by physicians. Prescribing opioids to chronic pain patients while restricting them to those who abuse them is very challenging, and physicians seek appropriate and unbiased prescribing guidelines. Our review, based on analysis of the available literature, focuses on striking a balance between overprescribing and underprescribing. The core concept of this strategy relies in using screening tools to identify patients who are at high risk for opioid abuse along with diligent monitoring using prescription monitoring programs and urine drug screens, while also limiting opioid doses. Hopefully, using these principles, physicians can more confidently prescribe opioids to those who would benefit from these powerful drugs and at the same time keep opioids away from those who could potentially be harmed. Key Words: abuse, addiction, chronic pain, dose limitation, misuse, monitoring, opioids, overdose, screening

Physicians' Role in Curbing the Worst Drug Crisis in America: Prescription Opioid Abuse

2018 ◽  
Author(s):  
Sairam Atluri ◽  
Gururau Sudarshan
Keyword(s):  
Chronic Pain ◽  
Opioid Abuse ◽  
Screening Tools ◽  
Prescription Drug Abuse ◽  
Prescription Opioid ◽  
Dose Limitation ◽  
Chronic Pain Patients ◽  
Urine Drug ◽  
Pain Patients ◽  
Prescription Opioid Abuse

Opioids have an important role in the management of acute, cancer, and chronic pain. However, their indiscriminate use in chronic pain has led, in part, to the epidemic of prescription drug abuse, resulting in a dramatic increase in morbidity and mortality in America. Most of this abuse originates from legitimate prescriptions by physicians. Prescribing opioids to chronic pain patients while restricting them to those who abuse them is very challenging, and physicians seek appropriate and unbiased prescribing guidelines. Our review, based on analysis of the available literature, focuses on striking a balance between overprescribing and underprescribing. The core concept of this strategy relies in using screening tools to identify patients who are at high risk for opioid abuse along with diligent monitoring using prescription monitoring programs and urine drug screens, while also limiting opioid doses. Hopefully, using these principles, physicians can more confidently prescribe opioids to those who would benefit from these powerful drugs and at the same time keep opioids away from those who could potentially be harmed. Key Words: abuse, addiction, chronic pain, dose limitation, misuse, monitoring, opioids, overdose, screening

Self-reports of prescription opioid abuse and diversion among recreational opioid users in a Canadian and a United States city

2015 ◽  
Vol 11 (6) ◽  
pp. 463 ◽  
Author(s):  
Beatrice Setnik, PhD ◽  
Carl L. Roland, PharmD, MS ◽  
Veeraindar Goli, MD ◽  
Glenn C. Pixton, MS ◽  
Naama Levy-Cooperman, PhD ◽  
...  
Keyword(s):  
United States ◽  
Salt Lake ◽  
Salt Lake City ◽  
The United States ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
The Us ◽  
Opioid Users ◽  
Prescription Opioid Abuse

Objective: To explore behaviors related to prescription opioid abuse and diversion in individuals who self-reported past recreational (nonmedical) opioid use.Design: A questionnaire was developed and included in two abuse potential clinical studies conducted in Canada (Toronto, ON, August 2010 to January, 2011) and the United States (Salt Lake City, UT, February-May 2011).Participants: Recreational opioid users.Main outcome measure(s): Self-reported behaviors related to prescription opioid abuse and diversion.Results: The questionnaire was completed by 174 participants in the Canadian study and 80 participants in the US study. Most participants reported that they used prescription opioids for nonmedical purposes a few times a month. Most had taken their first prescription opioid between the ages of 12 and 24 years and the two most common reasons were to treat pain or to feel high/stoned. When asked about specific opioids taken for nonmedical purposes in the past year, oxycodone, acetaminophen with codeine, and morphine were commonly used by both cohorts, whereas hydrocodone use was substantially greater in the US cohort versus the Canadian cohort. Participants reported various tampering methods and routes of administration, with swallowed whole, crushed and snorted, and chewed/crushed and swallowed as the most prevalent. Most participants indicated taking other drugs with prescription opioids to get high, most commonly marijuana and alcohol. The most common sources for obtaining prescription opioids were family/friends. Conclusions: Two cohorts of recreational opioid users from Canada and the United States reported similar experiences with various prescription opioids and indicated a predominance of diversion from family/friends.

scholarly journals Prescription Opioid Abuse in Chronic Pain: A Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. S67-ES92 ◽  
Author(s):  
Nalini Sehgal
Keyword(s):  
Chronic Pain ◽  
Opioid Therapy ◽  
Opioid Abuse ◽  
Screening Tools ◽  
Prescription Opioid ◽  
Prescribing Practices ◽  
Chronic Noncancer Pain ◽  
The Past ◽  
Noncancer Pain ◽  
Prescription Opioid Abuse

Both chronic pain and prescription opioid abuse are prevalent and continue to exact a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self medication, use for reward, compulsive use because of addiction, and diversion for profit. Treatment approaches that balance treating chronic pain while minimizing risks for opioid abuse, misuse, and diversion are much needed. The use of chronic opioid therapy for chronic noncancer pain has increased dramatically in the past 2 decades in conjunction with a marked increase in the abuse of prescribed opioids and accidental opioid overdoses. Consequently, a validated screening instrument that provides an effective and rational method of selecting patients for opioid therapy, predicting risk, and identifying problems once they arise could be of enormous benefit. Such an instrument could potentially curb the risk of iatrogenic addiction. Although several screening instruments and strategies have been introduced in the past decade, there is no single test or instrument that can reliably and accurately predict patients who are not suitable for opioid therapy or identify those who need increased vigilance or monitoring during therapy. At present, screening for opioid abuse includes assessment of premorbid and comorbid substance abuse; assessment of aberrant drug-related behaviors; risk factor stratification; and utilization of opioid assessment screening tools. Multiple opioid assessment screening tools and instruments have been developed by various authors. In addition, urine drug testing, monitoring of prescribing practices, prescription monitoring programs, opioid treatment agreements, and utilization of universal precautions are essential. Presently, a combination of strategies is recommended to stratify risk, identify and understand aberrant drug related behaviors, and tailor treatments accordingly. This manuscript will review the current state of knowledge regarding the growing problem of opioid abuse and misuse; known risk factors; and methods of predicting, assessing, monitoring, and addressing opioid abuse and misuse in patients with chronic noncancer pain. Key words: Opioids, misuse, abuse, chronic pain, prevalence, risk assessment, risk management, drug monitoring, aberrant drug-related behavior

scholarly journals National Drug Control Policy and Prescription Drug Abuse: Facts and Fallacies

2007 ◽  
Vol 3;10 (5;3) ◽  
pp. 399-424
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Substance Abuse ◽  
Drug Abuse ◽  
Drug Use ◽  
Prescription Drug ◽  
Control Policy ◽  
Prescription Drug Abuse ◽  
The Past ◽  
National Drug ◽  
Nonmedical Use ◽  
National Drug Control Policy

In a recent press release Joseph A. Califano, Jr., Chairman and President of the National Center on Addiction and Substance Abuse at Columbia University called for a major shift in American attitudes about substance abuse and addiction and a top to bottom overhaul in the nation’s healthcare, criminal justice, social service, and eduction systems to curtail the rise in illegal drug use and other substance abuse. Califano, in 2005, also noted that while America has been congratulating itself on curbing increases in alcohol and illicit drug use and in the decline in teen smoking, abuse and addition of controlled prescription drugs-opioids, central nervous system depressants and stimulants-have been stealthily, but sharply rising. All the statistics continue to show that prescription drug abuse is escalating with increasing emergency department visits and unintentional deaths due to prescription controlled substances. While the problem of drug prescriptions for controlled substances continues to soar, so are the arguments of undertreatment of pain. The present state of affairs show that there were 6.4 million or 2.6% Americans using prescription-type psychotherapeutic drugs nonmedically in the past month. Of these, 4.7 million used pain relievers. Current nonmedical use of prescription-type drugs among young adults aged 18-25 increased from 5.4% in 2002 to 6.3% in 2005. The past year, nonmedical use of psychotherapeutic drugs has increased to 6.2% in the population of 12 years or older with 15.172 million persons, second only to marijuana use and three times the use of cocaine. Parallel to opioid supply and nonmedical prescription drug use, the epidemic of medical drug use is also escalating with Americans using 80% of world’s supply of all opioids and 99% of hydrocodone. Opioids are used extensively despite a lack of evidence of their effectiveness in improving pain or functional status with potential side effects of hyperalgesia, negative hormonal and immune effects, addiction and abuse. The multiple reasons for continued escalation of prescription drug abuse and overuse are lack of education among all segments including physicians, pharmacists, and the public; ineffective and incoherent prescription monitoring programs with lack of funding for a national prescription monitoring program NASPER; and a reactive approach on behalf of numerous agencies. This review focuses on the problem of prescription drug abuse with a discussion of facts and fallacies, along with proposed solutions. Key words: Prescription drug abuse, opioid abuse, opioid misuse, National Drug Control Policy, NASPER, prescription drug monitoring programs.

Sign in / Sign up

Export Citation Format

Share Document