scholarly journals Declines and pronounced regional disparities in prescription opioid use in the United States

2021 ◽  
Author(s):  
Joshua D. Madera ◽  
Amanda E. Ruffino ◽  
Adriana Feliz ◽  
Kenneth L. McCall ◽  
Brian J. Piper
Keyword(s):  
United States ◽  
Regional Differences ◽  
The United States ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
The Past ◽  
The Us ◽  
Per Capita ◽  
Prescription Opioid Use

AbstractBackgroundThe United States (US) opioid epidemic is a persistent and pervasive public health emergency as it continues to claim the lives of Americans through addiction and overdose. There have been sustained efforts to reverse this iatrogenic crisis over the past decade. This study analyzed the changes in prescription opioid distribution for pain and identified regional differences between 2010 and 2019.Methods and FindingsOpioid production data was obtained from the DEA’s annual production quotas. Total opioid production has decreased 41.5% from 2013 (87.6 morphine mg equivalent metric tons) to 2019 (51.3). Opioid distribution from 2010 to 2019 was collected for ten prescription opioids (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, and tapentadol) from the US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System. Regional variance was expressed as the ratio of the 95th to 5th percentiles of opioid distribution per state, corrected for population. The peak year for all ten prescription opioids was identified, individually, as between 2010 and 2013, except for codeine (2015). There was a 51.96% overall decrease in opioid distribution per capita with the largest decrease in Florida (−61.61%) and smallest in Texas (−18.64%). The largest quantities of opioid distribution were observed in Tennessee (520.70 morphine mg equivalent or MME per person) and Delaware (251.45) in 2011 and 2019. The smallest was Nebraska (153.39) in 2011 and Minnesota (90.49) in 2019. The highest to lowest state ratio of total opioid use, corrected for population, was sizable in 2011 (5.25) and 2019 (2.78). Similarly, the mean 95th/5th ratio was relatively stable in from 2011 (4.78 +0.70) and 2019 (5.64+0.98). The 95th/5th ratio in 2019 was greatest for methadone (10.23) and oxymorphone (10.09) and smallest for morphine (2.20) and fentanyl (2.12). Southern states (e.g MS, TN, AL, AK, DE, and NC) had the highest per capita distribution for eight of the ten opioids in 2019. The strength of the correlation between per capita hydrocodone and codeine, and hydromorphone and codeine increased significantly from 2011 to 2019ConclusionsThis study found a decline in total production and distribution for ten prescription opioids during the last half-decade. However, distribution was non-homogeneous at a state level. Analysis of regional differences revealed a three-fold difference in the 95th:5th percentile ratio between states which was unchanged over the past decade. Future research focused on identifying factors contributing to the observed regional variability could prove valuable to understanding, and potentially remediating, the pronounced disparities in prescription opioid use in the US.

Chronic prescription opioid use in pregnancy in the United States

2021 ◽  
Author(s):  
Loreen Straub ◽  
Krista F. Huybrechts ◽  
Sonia Hernandez‐Diaz ◽  
Yanmin Zhu ◽  
Seanna Vine ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use ◽  
In Pregnancy

scholarly journals Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States

2018 ◽  
Vol 175 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Mark Olfson ◽  
Melanie M. Wall ◽  
Shang-Min Liu ◽  
Carlos Blanco
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Use Disorder ◽  
Cannabis Use ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

Internet-based Survey of Nonmedical Prescription Opioid Use in the United States

2008 ◽  
Vol 24 (6) ◽  
pp. 528-535 ◽  
Author(s):  
Nathaniel Katz ◽  
Kathrine Fernandez ◽  
Alan Chang ◽  
Christine Benoit ◽  
Stephen F. Butler
Keyword(s):  
United States ◽  
The United States ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals National Patterns in Prescription Opioid Use and Misuse Among Cancer Survivors in the United States

2020 ◽  
Vol 3 (8) ◽  
pp. e2013605
Author(s):  
Vikram Jairam ◽  
Daniel X. Yang ◽  
Vivek Verma ◽  
James B. Yu ◽  
Henry S. Park
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
The United States ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals Prescription Opioid Use and Laboratory Value Derangements: A Cross-Sectional Analysis of NHANES Data

2020 ◽  
Vol 1;24 (1;1) ◽  
pp. E95-E100
Keyword(s):  
Pain Management ◽  
Reference Range ◽  
Comparison Group ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
Cross Sectional ◽  
Laboratory Values ◽  
The Us ◽  
Prescription Opioid Use

BACKGROUND: The use of opioids for the treatment of pain is a risk versus benefit analysis and metabolic disease is an often overlooked variable in the equation and may lead to increased risk of comorbidities of cardiovascular and cerebrovascular disease and diabetes. OBJECTIVES: Our objective was to identify and describe abnormalities among the comprehensive metabolic and lipid panels of individuals taking prescription opioids. STUDY DESIGN: We performed a cross-sectional study of the laboratory values with 3 cycles (2011–2016) of the National Health and Nutrition Examination Survey (NHANES) in March 2020. SETTING: NHANES sampling is conducted using a multistaged, stratified, cluster sampling technique to create a representative sample of the United States. METHODS: We excluded patients with histories of cancer and under the age of 25 years. Our final sample size was 11,061 (n = 162,547,635), with 797 reportedly using a prescription opioid in the past 30 days—a weighted percent representing 22.95% of the US population. Our analyses identified mean differences in biomarkers between individuals taking prescription opioids and the US population. RESULTS: Laboratory values from the comprehensive metabolic panel were all within reference ranges for both groups, with only bilirubin levels being statistically lower in the group currently taking prescription opioids. Values from the lipid panel of both the opioid using and comparison groups were above reference range for total cholesterol and fasting glucose. The opioid using group was also higher than the reference range for triglycerides (mean [M] = 165.4, standard deviation [SD] = 14.2) and insulin (M = 15.5, SD = 2.2), whereas the comparison group was not. The oral glucose measure was within normal ranges for both groups; however, the opioid using group was 13.7 points higher than the comparison group (M = 122.3, SD = 1.8; M = 108.6, SD = 4.0; P < 0.01). LIMITATIONS: While our study uses a large sample for a robust generalizable analysis it is a correlation study and a longitudinal cohort would provide better evidence linking potential disease states to prescription opioid use. CONCLUSIONS: Although all Americans should be alarmed at the lipid levels reported in this study, specific combinations of heightened lipid laboratory values among prescription opioid users accelerate the trajectories toward comorbidities—heart disease, cerebrovascular disease, and diabetes—leading to diminished quality of life. Therefore pain management and comprehensive drug recovery programs should include nutritional counseling and physical activity as part of their overall treatment plan. KEY WORDS: Opioid use, NHANES, pain management, lab values, analgesics

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.

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