Prescription opioid misuse motive latent classes: outcomes from a nationally representative US sample

Abstract Aims Prescription opioid misuse (POM) contributes to a larger opioid crisis in the US and Canada, with over 17 000 US POM-related overdose deaths in 2017. Our aims were to (1) identify specific profiles of respondents based on POM motives using the US National Survey on Drug Use and Health (NSDUH) and (2) compare profile respondents on sociodemographics, substance use and mental and physical health outcomes. Methods Analyses included 2017–18 NSDUH respondents with data on POM motives (n = 4810). POM was defined as prescription opioid use in a way not intended by the prescriber, including use without a prescription, in larger amounts or more frequently. Nine POM motives for the most recent episode were assessed, including ‘to relieve physical pain’ and ‘to get high’. Latent classes, based on POM motives, were estimated. Classes were compared on sociodemographics, substance use and physical and mental health outcomes. Results Eight latent classes were identified (in order of prevalence): pain relief only, relax-pain relief, sleep-pain relief, multi-motive, high, experimenter, emotional coping and dependent/hooked. Compared to the pain relief only group, the high and multi-motive classes had higher odds of all substance use outcomes, with the dependent/hooked class having higher odds on all but one outcome. Six of the eight classes had higher odds of past-year mental health treatment and suicidal ideation than the pain relief only class. Conclusions Screening for pain, pain conditions, problematic substance use and psychopathology are recommended in those with any POM. While those in the dependent/hooked, multi-motive and emotional coping classes are most likely to have prescription opioid use disorder (OUD), screening for OUD symptoms in all individuals with POM is also warranted.

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Prevalence and Detection of Prescription Opioid Misuse and Prescription Opioid Use Disorder Among Emergency Department Patients 50 Years of Age and Older: Performance of the Prescription Drug Use Questionnaire, Patient Version

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2016.03.010 ◽

2016 ◽

Vol 24 (8) ◽

pp. 627-636 ◽

Cited By ~ 9

Author(s):

Francesca L. Beaudoin ◽

Roland C. Merchant ◽

Melissa A. Clark

Keyword(s):

Emergency Department ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Patient Version ◽

Prescription Drug Use ◽

Emergency Department Patients ◽

Prescription Opioid Misuse ◽

Prescription Opioid Use

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Screening for depression among a sample of US college students who engage in recreational prescription opioid misuse

Health Promotion Perspectives ◽

10.15171/hpp.2020.10 ◽

2020 ◽

Vol 10 (1) ◽

pp. 59-65

Author(s):

Robert E. Davis ◽

Martha A. Bass ◽

M. Allison Wade ◽

Vinayak K. Nahar

Keyword(s):

College Students ◽

Substance Use ◽

Depressive Symptomatology ◽

Opioid Use Disorder ◽

Screening Tools ◽

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Positive Screen ◽

Prescription Opioid Misuse

Background: Among student populations, literature has identified associations between prescription opioid misuse and symptoms of depression such as hopelessness, sadness, and emotional pain. Thus far, existing literature has yet to investigate associations between prescription opioid misuse and depression using validated screening instruments for depression when exploring such associations. The purpose of this study was to utilize a validated screening tool to explore quantifiable presence of depression among college students who engage in recreational prescription opioid misuse (RPOM). Additionally, gender differences in depression and co-occurring substance use are examined. Methods: Students (n = 104) of a large university in the Southeastern United States who reported ROM within the past 6 months completed instrumentation assessing demographics, substance use, as well as, screening tools for depression and possible opioid use disorder (OUD). Results: Positive depression screens were significantly higher among females, however, nearly56% of participants screened positive for major depression. Though high levels of co-occurring substance use were observed among the entire sample, males were significantly more likely to report cocaine use, more frequent use of alcohol and marijuana, as well as, exhibit a positive screen for disordered opioid use, at a rate 5 times that of their female counterparts. Conclusion: Students who engage in RPOM are a particularly heightened-risk subsample of the college population who exhibit high levels of depressive symptomatology and substance use behavior. Targeted programming and further investigations are needed among this specific population. Future studies are encouraged to utilize validated instruments when assessing depression among students.

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Managing Pain in Patients with a History of a Substance Use Disorder

10.1093/med/9780199981830.003.0008 ◽

2018 ◽

Author(s):

Martin D. Cheatle

Keyword(s):

Chronic Pain ◽

Substance Use ◽

Opioid Use Disorder ◽

Mitigation Strategies ◽

Scholarly Activity ◽

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Health Crisis ◽

Prescription Opioid Misuse

Patients with chronic pain tend to be complex and can present with multiple comorbidities, including anxiety, depression, functional disabilities, and substance misuse or abuse. The burgeoning rate of prescription opioid misuse and abuse and opioid-related fatalities has generated a great deal of scholarly activity on understanding the etiology of opioid misuse/abuse and developing risk assessment and mitigation strategies to curb this public health crisis. Balancing effective pain management and reducing the risk of opioid misuse/abuse and diversion can be a daunting endeavor, as is controlling pain in patients with pain and concomitant substance use disorders. This chapter provides an overview of the prevalence of opioid misuse/abuse in patients with chronic pain. It covers pharmacologic and nonpharmacologic therapies for patients with pain and co-occurring opioid use disorder and also discusses the challenges and opportunities to improve pain care and reduce misuse and abuse of opioids.

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Prescription Opioid Misuse Motives in US Older Adults

Pain Medicine ◽

10.1093/pm/pnz304 ◽

2019 ◽

Vol 21 (10) ◽

pp. 2237-2243 ◽

Cited By ~ 3

Author(s):

Ty S Schepis ◽

Linda Wastila ◽

Beth Ammerman ◽

Vita V McCabe ◽

Sean Esteban McCabe

Keyword(s):

Older Adults ◽

Substance Use ◽

Pain Relief ◽

Logistic Models ◽

Prescription Opioid ◽

Opioid Misuse ◽

Physical Pain ◽

Prescription Opioid Misuse ◽

Mental And Physical Health ◽

Mixed Motives

Abstract Objectives To evaluate age-based differences in prescription opioid misuse (POM) motives and to evaluate substance use and mental and physical health correlates of POM motive categories in older adults. Design Data were from the National Survey on Drug Use and Health (NSDUH), a nationally representative US survey. Setting The NSDUH is a household survey. Subjects A total of 5,826 US residents with past-year POM; 415 were 50 years and older (7.1%). Methods Nine POM motives were assessed among those engaged in past-year POM, grouped into three categories: solely physical pain relief, solely non–pain relief, or mixed motives. Prevalence of POM motives were calculated by age group, with logistic models examining age-based differences. Finally, odds of substance use and mental and physical health correlates by motive category were calculated via logistic models in older adults. Results POM motivated solely by physical pain relief increased from 35.1% in young adults to 65.4% in older adults; in older adults, 84.7% of POM episodes involved pain relief as a motive. POM for solely non–pain relief or mixed motives was associated with greater odds, vs pain relief only, of past-year benzodiazepine misuse (odds ratio [OR] = 4.43 and 6.15, respectively), any substance use disorder (OR = 5.57 and 5.60, respectively), and suicidal ideation (OR = 4.05 and 3.56, respectively) in older adults. Conclusions . POM motives change over the lifespan, with increasing POM for pain relief with aging. Comprehensive nonopioid pain management is needed for those engaged in POM for pain relief, and substance use and mental health treatment are needed for those with non–pain relief motives.

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Borderline Features and Prescription Opioid Misuse in a Substance Use Disorder Treatment Sample

Substance Use & Misuse ◽

10.1080/10826084.2018.1512626 ◽

2018 ◽

Vol 54 (1) ◽

pp. 166-175 ◽

Cited By ~ 3

Author(s):

Noel Vest ◽

Sarah Tragesser

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Prescription Opioid ◽

Opioid Misuse ◽

Substance Use Disorder Treatment ◽

Disorder Treatment ◽

Prescription Opioid Misuse

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Prescription Opioid Use in Adolescence and Opioid Misuse Post-Adolescence: A Concerning Study Worth Knowing About

10.1542/9781610022798-knowing_about ◽

2018 ◽

pp. 46-46

Keyword(s):

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Prescription Opioid Use

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Social Media as an Emerging Tool for Reducing Prescription Opioid Misuse Risk Factors (Preprint)

10.2196/preprints.12294 ◽

2018 ◽

Author(s):

Sean Young ◽

Sung-Jae Lee ◽

Hendry Perez ◽

Navkiran Gill ◽

Lillian Gelberg ◽

...

Keyword(s):

Social Media ◽

Chronic Pain ◽

Online Community ◽

Prescription Opioid ◽

Control Group ◽

Opioid Misuse ◽

Opioid Use ◽

Online Behavior ◽

Prescription Opioid Misuse

BACKGROUND Interventions are urgently needed to reduce prescription opioid misuse risk factors, including anxiety and concomitant use of sedatives. However, only 5 randomized controlled opioid intervention trials have been conducted, with none showing improvements in anxiety. OBJECTIVE We sought to determine the feasibility of using an online behavior change community, compared to a control Facebook group, to reduce anxiety and opioid misuse among chronic pain patients. METHODS 51 high-risk non-cancer chronic pain patients were randomly assigned to either a Harnessing Online Peer Education (HOPE) peer-led online behavior change intervention or a control group (no peer leaders) on Facebook for 12 weeks. Inclusion criteria were: 18 years or older, a UCLA Health System patient, prescribed an opioid for non-cancer chronic pain between 3 and 12 months ago, and a score of ≥ 9 on the Current Opioid Misuse Measure (COMM) and/or concomitant use of benzodiazepines. Participation in the online community was voluntary. Patients completed baseline and follow-up assessments on Generalized Anxiety Disorder screener (GAD-7), COMM, and frequency of social media discussions about pain and opioid use. RESULTS Compared to control group participants, intervention participants showed a baseline-to-follow-up decrease in anxiety, and more frequently used social media to discuss pain, prescription opioid use, coping strategies, places to seek help, and alternative therapies for pain. Both groups showed a baseline to follow-up decrease in COMM score. CONCLUSIONS Results support the feasibility of using an online community interventions as a low-cost tool to decrease risk for prescription opioid misuse and its complications. CLINICALTRIAL ClinicalTrials.gov: NCT02735785

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Identifying a Need for Mental Health Services Posthospitalization in Adolescent Trauma Patients

Proceedings of IMPRS ◽

10.18060/24631 ◽

2020 ◽

Vol 3 ◽

Author(s):

Alexandra Hochstetler ◽

Ashley Vetor ◽

Jodi Raymond ◽

Hannah Bozell ◽

Teresa Bell

Keyword(s):

Mental Health ◽

Substance Use ◽

Alcohol Use ◽

Mental Health Disorders ◽

Pain Severity ◽

Pain Interference ◽

Prescription Opioid ◽

Opioid Use ◽

Health Disorders ◽

Prescription Opioid Use

Background: Nearly 150,000 children were hospitalized due to an injury in 2018. Hospitalized patients are often prescribed opioids and as a result, one in eight adolescents will continue using opioids twelve months after hospitalization. Predictors of sustained opioid use and future misuse posthospitalization have yet to be studied in adolescents. One of these predictors may be mental health disorders following hospitalization. It is known mental health disorders can lead to substance use disorders if not addressed properly. In this study we examined the associations between injury severity, mental health, and substance use among adolescents. Methods: Patients between 12 to 18 years old admitted for trauma were surveyed upon enrollment, and subsequently at 1, 3, 6, and 12 months posthospitalization. These surveys measured anxiety, depression, posttraumatic stress, prescription and non-prescription drug use, pain severity and pain interference. Results: At enrollment and one-month posthospitalization, higher pain interference was associated with anxiety (p=.003), depression (p<.001), and PTSD (p=.004). Increased pain severity was also associated with higher PTSD (p=.003) However, at three months, pain severity and interference were only associated with PTSD (p=.005, p=.009). Frequent alcohol use and higher PTSD were found to be statistically significant at six and twelve months (p=.02). Regular prescription opioid use was related to higher anxiety (p=.048) and depression (p=.048) only at enrollment and higher PTSD only at one month (p=.034). Prescription opioid use was not associated with pain severity and interference at enrollment but was found significant at one month (p=.016, p=.36). Conclusion: Adolescents who reported higher pain severity and interference also more commonly had mental health disorders such as PTSD, anxiety, and depression. Higher PTSD scores and frequent alcohol use were also related post-injury. Screening for mental health after hospitalization should be further investigated in identifying adolescents who may be at risk for future opioid use disorders.

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