Illicit Drug Use and Substance Abuse

BACKGROUND:Many physicians are overly cautious about prescribing opioids for chronic pain because of fears of iatrogenic addiction. However, in patients with chronic pain, addiction to opioid analgesics is exceedingly rare when there is no prior history of alcohol or drug abuse.OBJECTIVE:To validate an instrument that separates possible opioid abusers from those who are at low risk.DESIGN/METHODS:The Screening Instrument for Substance Abuse Potential (SISAP) was designed to identify individuals with a possible substance abuse history quickly and accurately. It is based on the National Alcohol and Drug Use Survey (n=9915). Using the first half of the sample (n=4967), two previously validated alcohol use items were combined with three illicit drug use items. These five questions identified those with a history of alcohol and/or illicit drug use.RESULTS:Using the second half of the sample (n=4948), the validation procedure showed that the five combined items correctly classified 91% of substance abusers and had a low rate of false negatives.DISCUSSION:The SISAP is brief and resistant to misrepresentation or falsification. The SISAP is expected to improve pain management by facilitating focus on the appropriate use of opioid analgesics and therapeutic outcomes in the majority of patients who are not at risk of opioid abuse, while carefully monitoring those who may be at greater risk.

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Prevalence of Illicit Drug use in Patients without Controlled Substance Abuse in Interventional Pain Management

January 2018 - Pain Physician ◽

10.36076/ppj.2003/6/173 ◽

2003 ◽

Vol 2;6 (4;2) ◽

pp. 173-178

Author(s):

Laxmaiah Manchikanti

Keyword(s):

Substance Abuse ◽

Pain Management ◽

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use ◽

Interventional Pain Management ◽

Controlled Substance

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Psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients

Journal of Opioid Management ◽

10.5055/jom.2007.0045 ◽

2007 ◽

Vol 3 (2) ◽

pp. 89 ◽

Cited By ~ 100

Author(s):

Laxmaiah Manchikanti, MD ◽

James Giordano, PhD ◽

Mark V. Boswell, MD, PhD ◽

Bert Fellows, MA ◽

Rajeev Manchukonda, BDS ◽

...

Keyword(s):

Substance Abuse ◽

Chronic Pain ◽

Drug Abuse ◽

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use ◽

Opioid Abuse ◽

Somatization Disorder ◽

Chronic Pain Patients ◽

Pain Patients

Background: Psychopathology (depression, anxiety, somatization disorder) and substance abuse (opioid mis-use and illicit drug use) are common in patients with chronic pain and present problems for public health and clinical management. Despite a body of literature describing various methods for identifying psychopathology, opioid misuse, and illicit drug use in chronic pain patients, the relationship between psychopathologies, substance abuse, and chronic pain has not been well characterized.Methods: This report describes a total of500 consecutive pain patients prescribed and receiving stable doses of opioids. The patients were evaluated for psychopathology, opioid abuse, and illicit drug use during the course of regular pain management treatment. The relationships between psychopathology and drug abuse and/or illicit drug use in chronic pain patients were examined, and psychological evaluation for depression, anxiety, and somatization disorder was performed.Results: Depression, anxiety, and somatization disorder were documented in 59, 64, and 30percent of chronic pain patients, respectively. Drug abuse was significantly higher in patients with depression as compared to patients without depression (12percent with depression versus 5percent without). Current illicit drug use was higher in women with depression (22 percent) than women without depression (14percent) and in men with or without depression (12percent). Current illicit drug use was also higher in men with somatization disorder (22 percent) than men without (9 percent).Conclusion: This study demonstrated that the presence of psychological features of depression and somatization disorder may be markers of substance abuse diathesis in chronic pain patients.

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The impact of alcohol and illicit drugs on people with psychosis: The second Australian national survey of psychosis

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867412443900 ◽

2012 ◽

Vol 46 (9) ◽

pp. 864-878 ◽

Cited By ~ 39

Author(s):

Elizabeth Moore ◽

Serafino G Mancuso ◽

Tim Slade ◽

Cherrie Galletly ◽

David J Castle

Keyword(s):

Substance Abuse ◽

Drug Use ◽

Alcohol Abuse ◽

Illicit Drug ◽

Illicit Drug Use ◽

Integrated Treatment ◽

National Study ◽

Cannabis Dependence ◽

Cannabis Abuse ◽

The Impact

Objective: To provide the most up-to-date prevalence estimates of alcohol and illicit drug use among individuals with psychosis in Australia, and explore correlates associated with a lifetime diagnosis of both alcohol abuse/dependence and cannabis abuse/dependence. Method: This paper uses data from the Survey of High Impact Psychosis (SHIP), conducted as a follow-up to the first Australian National Low Prevalence (Psychotic) Disorders Study (1997–1998). The SHIP was a national study, carried out across five states, in which a sample of 1825 individuals was recruited through a two-phase sampling framework. Results: Alcohol and illicit drug use was highly prevalent for the entire sample. There were few significant differences in the prevalence or frequency of use across the diagnostic categories examined. Substantial increases in substance abuse/dependence were noted since the 1997–1998 survey (51% diagnosed with alcohol abuse/dependence, 51% with cannabis abuse/dependence and 32% with other illicit drug abuse/dependence, compared to 28%, 23% and 12% respectively, in the 1997–1998 survey by Kavanagh et al., 2004). Factors significantly associated with both lifetime alcohol and cannabis dependence included male gender, younger age, single marital status, lower educational attainment, shorter duration of illness, lifetime presence of hallucinations, higher negative syndrome score and lower body mass index (BMI). A number of other factors were found to be differentially associated with either lifetime alcohol or cannabis dependence. Conclusions: The use of alcohol and illicit substances is common among people with a psychotic illness, with a concerning upward trend in rates of substance abuse/dependence since the 1997–1998 survey. Clinicians should be aware of the potential impact of concurrent substance use and provide integrated treatment for individuals presenting with psychotic illnesses. More research and investment in new intervention programs is required.

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