Identification of Distinct Etiologies across Prescription Misuse and Illicit Drug Use: Opioids and Stimulants Compared

2020 ◽  
Author(s):  
Genevieve Fullerton Dash ◽  
Nicholas G. Martin ◽  
Arpana Agrawal ◽  
Michael Lynskey ◽  
Wendy S. Slutske
Keyword(s):  
Illicit Drugs ◽  
Genetic Influence ◽  
Prescription Opioid ◽  
Future Research ◽  
Opioid Use ◽  
Stimulant Use ◽  
Drug Classes ◽  
Illicit Use ◽  
Prescription Opioid Misuse ◽  
Illicit Opioid Use

Background. Drug classes are grouped based on their chemical and pharmacological properties, but prescription and illicit drugs differ in other important ways. Opioid and stimulant classes contain prescription and illicit forms differentially associated with salient risk factors (common route of administration, legality), making them useful comparators for examining the potential differences in the etiological influences on (mis)use of prescription and illicit drugs. Methods. 2,410 individual Australian twins (Mage=31.77 [SD=2.48]; 67% women) were interviewed about prescription misuse and illicit use of opioids and stimulants. Univariate and bivariate biometric models partitioned variances and covariances into additive genetic, shared environmental, and unique environmental influences across drug types. Results. Variation in the propensity to misuse prescription opioids was primarily attributable to genes (37%) and unique environment (59%). Illicit opioid use was attributable to shared (71%) and unique (29%) environment. Prescription stimulant misuse was primarily attributable to genes (78%) and unique environment (21%). Illicit stimulant use was influenced by genes (48%), and shared (29%) and unique environment (23%). There was evidence for genetic influence common to both stimulant types, but limited evidence for genetic influence common to both opioid types. Conclusions. Prescription opioid misuse may share little genetic influence with illicit opioid use. Future research may consider avoiding unitary drug classifications, particularly when examining genetic influences.

Are prescription misuse and illicit drug use etiologically distinct? A genetically-informed analysis of opioids and stimulants

2021 ◽  
pp. 1-8
Author(s):  
Genevieve F. Dash ◽  
Nicholas G. Martin ◽  
Arpana Agrawal ◽  
Michael T. Lynskey ◽  
Wendy S. Slutske
Keyword(s):  
Illicit Drugs ◽  
Environmental Influences ◽  
Genetic Influence ◽  
Prescription Opioid ◽  
Future Research ◽  
Shared Environment ◽  
Opioid Use ◽  
Stimulant Use ◽  
Prescription Opioid Misuse ◽  
Illicit Opioid Use

Abstract Background Drug classes are grouped based on their chemical and pharmacological properties, but prescription and illicit drugs differ in other important ways. Potential differences in genetic and environmental influences on the (mis)use of prescription and illicit drugs that are subsumed under the same class should be examined. Opioid and stimulant classes contain prescription and illicit forms differentially associated with salient risk factors (common route of administration, legality), making them useful comparators for addressing this etiological issue. Methods A total of 2410 individual Australian twins [Mage = 31.77 (s.d. = 2.48); 67% women] were interviewed about prescription misuse and illicit use of opioids and stimulants. Univariate and bivariate biometric models partitioned variances and covariances into additive genetic, shared environmental, and unique environmental influences across drug types. Results Variation in the propensity to misuse prescription opioids was attributable to genes (41%) and unique environment (59%). Illicit opioid use was attributable to shared (71%) and unique (29%) environment. Prescription stimulant misuse was attributable to genes (79%) and unique environment (21%). Illicit stimulant use was attributable to genes (48%), shared environment (29%), and unique environment (23%). There was evidence for genetic influence common to both stimulant types, but limited evidence for genetic influence common to both opioid types. Bivariate correlations suggested that prescription opioid use may be more genetically similar to prescription stimulant use than to illicit opioid use. Conclusions Prescription opioid misuse may share little genetic influence with illicit opioid use. Future research may consider avoiding unitary drug classifications, particularly when examining genetic influences.

Demographic characteristics, medical and psychiatric history of patients with prescription opioid use disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S300-S301
Author(s):  
S. Herrera ◽  
A. Riquelme ◽  
T. León ◽  
M. Babul
Keyword(s):  
Opioid Analgesics ◽  
The United States ◽  
Opioid Use Disorder ◽  
Demographic Characteristics ◽  
Prescription Opioid ◽  
Psychiatric History ◽  
Opioid Use ◽  
History Of ◽  
Competing Interest ◽  
Prescription Opioid Misuse

IntroductionOver the past two decades the prescription of opioid analgesics has increased with a subsequent escalating in prescription opioid misuse. It is estimated that 4.5 million (2.5%) of the United States of America population abuse of pain relievers; opioids are among the most commonly.In Chile there are few reports about the prevalence of opioid use disorder.ObjectivesThe aim of this study is to describe the demographic characteristics, medical and psychiatric comorbidity of patients that suffer from opioid addiction.Patients and methodsThis transversal study examined data of 7 patients with opioid use disorder (OUD; DSM-5) that consulted at the addiction unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between November 2013 and October 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.ResultsOf all the patients, 57% were men, 25 to 67 years of age, 43% between 35-40 years; 57% were married; 57% had completed studies at university. 43% had also alcohol use disorder, 28% marijuana, 28% cocaine and 28% benzodiazepines than in most cases began before OUD. In addition; 57% had medical comorbidity among which stand out obesity (17%), osteoarthritis (17%) and chronic low back pain (17%). Eighty-three percent require hospitalization. Twenty-eight percent had abnormal liver tests and one patient had positive hepatitis B core antibody. Opioids used were: morphine(14%), codeine (43%), tramadol (42%).ConclusionThese results emphasize on the misuse of prescription opioids analgesics, the complexity of patients with OUD and the prevalence of other substance use disorder that precedes and accompany OUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

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

Psychosocial interventions for chronic pain and comorbid prescription opioid use disorders: A narrative review of the literature

2018 ◽  
Vol 14 (5) ◽  
pp. 345-358 ◽  
Author(s):  
Valerie Hruschak, MSW ◽  
Gerald Cochran, PhD ◽  
Ajay D. Wasan, MD, MSc
Keyword(s):  
Chronic Pain ◽  
Psychosocial Interventions ◽  
Treatment Modalities ◽  
Prescription Opioid ◽  
Future Research ◽  
Motivational Enhancement Therapy ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Chronic Noncancer Pain ◽  
Opioid Use Disorders

Objective: Opioid misuse in the context of chronic noncancer pain (CNCP) is a multifaceted and complex issue. As opioid misuse and corresponding rates of addiction and overdose deaths exceed epidemic proportions, there is an urgent need for research in this area. The objective of this review is to evaluate the literature addressing psychosocial interventions targeting CNCP and prescription opioid misuse.Design: A systematic search of PubMed, MEDLINE, PsychINFO, ClinicalTrials. gov was conducted to identify studies evaluating psychosocial interventions targeting CNCP and prescription opioid misuse. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results: 56 peer-reviewed research articles from 1993 to July, 2016, which included studies of psychosocial interventions for CNCP and opioid use disorders. Studies that examined psychosocial interventions for CNCP, treatment modalities included: cognitive behavioral therapy (CBT), acceptance and commitment therapy, mindfulness-based cognitive therapy and mindfulness-based stress reduction, and chronic pain self-management programs. The psychosocial interventions for opioid misuse included: CBT and relapse prevention, motivational enhancement therapy and stages of change, contingency management, and self-help and peer support-based groups.Conclusions: The findings of this review offer clinical insight and reinforce the importance of psychosocial interventions in CNCP and opioid use disorders. However, little empirical data are available to guide practitioners in treating patients with CNCP who misuse opioid medications, and thus future research on integrated approaches, is needed.

scholarly journals A gender-based analysis of nonmedical prescription opioid use among people who use illicit drugs

2019 ◽  
Vol 97 ◽  
pp. 42-48 ◽  
Author(s):  
Tessa Cheng ◽  
Ekaterina Nosova ◽  
Will Small ◽  
Robert S. Hogg ◽  
Kanna Hayashi ◽  
...  
Keyword(s):  
Illicit Drugs ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Gender Based ◽  
Prescription Opioid Use

scholarly journals ‘Resurgent’, ‘twin’ or ‘silent’ epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Benedikt Fischer ◽  
Caroline O’Keefe-Markman ◽  
Angelica (Min-Hye) Lee ◽  
Dimitri Daldegan-Bueno
Keyword(s):  
Public Health ◽  
North America ◽  
Illicit Drugs ◽  
Crack Cocaine ◽  
The United States ◽  
Opioid Use ◽  
Drug Problem ◽  
Public Health Burden ◽  
Stimulant Use ◽  
Prevention And Treatment

AbstractIn the early 2000s, increasing prevalence of psycho-stimulant (e.g., crack/cocaine, methamphetamine) use and related harms, including severe adverse health outcomes, was observed among - mostly marginalized - populations of persons using illicit drugs in North America, underscoring an urgent need for interventions options towards improved prevention and treatment. By about 2010, however, the ‘opioid crisis’, featuring unprecedented use and public health burden, had accelerated into full force in North America, largely muting attention to the psycho-stimulant issue until recently. Recent surveillance data on drug use and related mortality/morbidity from the present decade has documented a marked resurgence of psycho-stimulant use and harms especially in at-risk populations, commonly in direct combination with opioids, across North America, resulting in a ‘twin epidemic’ comprised of opioids and psycho-stimulants We briefly review select epidemiological data indicators for these developments from the United States and Canada; in the latter jurisdiction, related evidence has been less prevalent and systematic but corroborating the same trends. Evidently, the (widely ongoing) focus on the ‘opioid epidemic’ as a ‘mono-type’ drug problem has become an anachronism that requires urgent and appropriate correction. We then briefly consider existing, evidence-based options for – prevention and treatment – interventions targeting psycho-stimulant use and harms, which are substantially more limited and/or less efficacious than those available for problematic opioid use, while presenting major gaps and challenges. The observed resurgence of psycho-stimulants may, indirectly, relate to recent efforts towards curtailing (medical) opioid availability, thereby accelerating demand and supply for both illicit opioids and psycho-stimulants. The presently unfolding ‘twin epidemic’ of opioids and psycho-stimulants, combined with limited intervention resources, presents an acute challenge for public health and may crucially undermine actively extensive efforts to reduce opioid-related health harms in North America.

scholarly journals Trends in Opioid Misuse among Marijuana Users and Non-Users in the U.S. from 2007–2017

2019 ◽  
Vol 16 (22) ◽  
pp. 4585
Author(s):  
Sunday Azagba ◽  
Lingpeng Shan ◽  
Lauren Manzione ◽  
Fares Qeadan ◽  
Mark Wolfson
Keyword(s):  
United States ◽  
Drug Use ◽  
Statistical Significance ◽  
Marijuana Use ◽  
The United States ◽  
Health Concern ◽  
Prescription Opioid ◽  
Future Research ◽  
Opioid Misuse ◽  
Prescription Opioid Misuse

Prescription-opioid misus e continues to be a significant health concern in the United States. The relationship between marijuana use and prescription-opioid misuse is not clear from the extant literature. This study examined national trends in prescription-opioid misuse among marijuana users and non-users using the 2007–2017 National Survey on Drug Use and Health. Cochran–Armitage tests were used to assess the statistical significance of changes in the yearly prevalence of prescription-opioid misuse and marijuana use. Multivariable logistic regression was used to examine the association between prescription-opioid and marijuana use adjusting for sociodemographic characteristics. From 2007 to 2017, marijuana use increased, while prescription-opioid misuse declined. Larger declines in prescription-opioid misuse were found among marijuana users than non-users. Marijuana ever-use was significantly associated with prescription-opioid misuse. Specifically, marijuana ever-users had higher odds of prescription-opioid misuse (ever-misuse [OR: 3.04; 95% CI, 2.68–3.43]; past-year misuse [OR: 3.44; 95% CI, 3.00–3.94]; and past-month misuse [OR: 4.50; 95% CI, 3.35–6.05]) compared to marijuana never-users. Similar results were found for the association of past-year and past-month marijuana use with prescription-opioid misuse. This study provides data on trends and associations about opioid misuse among marijuana users and non-users in a changing social environment of drug use in the United States. Future research should consider whether there is a causal relationship between marijuana use and prescription opioid misuse.

scholarly journals Polysubstance Use: A Broader Understanding of Substance Use During the Opioid Crisis

2020 ◽  
Vol 110 (2) ◽  
pp. 244-250 ◽  
Author(s):  
Theodore J. Cicero ◽  
Matthew S. Ellis ◽  
Zachary A. Kasper
Keyword(s):  
Substance Use ◽  
Supply And Demand ◽  
The United States ◽  
National Sample ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Polysubstance Use ◽  
Drug Classes ◽  
Global Nature ◽  
Illicit Opioid Use

Objectives. To understand important changes in co-occurring opioid and nonopioid drug use (i.e., polysubstance use) within the opioid epidemic in the United States. Methods. We analyzed survey data on the past month co-use of prescription and illicit opioids and 12 nonopioid psychoactive drug classes from a national sample of 15 741 persons entering treatment of opioid use disorder. Results. Past-month illicit opioid use increased from 44.8% in 2011 to 70.1% in 2018, while the use of prescription opioids alone dropped from 55.2% to 29.9%, yet overall remained high (94.5% to 85.2%). Past-month use of at least 1 nonopioid drug occurred in nearly all participants (> 90%), with significant increases in methamphetamine (+85%) and decreases across nonopioid prescription drug classes (range: −40% to –68%). Conclusions. Viewing opioid trends in a “silo” ignores the fact not only that polysubstance use is ubiquitous among those with opioid use disorder but also that significant changes in polysubstance use should be monitored alongside opioid trends. Public Health Implications. Treatment, prevention, and policymaking must address not only the supply and demand of a singular drug class but also the global nature of substance use overall.

scholarly journals Prescription opioid dispensing in Canada: an update on recent developments to 2018

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Wayne Jones ◽  
Lenka Vojtila ◽  
Paul Kurdyak ◽  
Benedikt Fischer
Keyword(s):  
Control Measures ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Community Based ◽  
Defined Daily Doses ◽  
Sample Data ◽  
Recent Developments ◽  
Strong Opioids ◽  
Dispensing Data ◽  
Illicit Opioid Use

Abstract Canada has been home to comparatively extreme developments in prescription opioid (PO) availability and related harms (e.g. morbidity, mortality) post-2000. Following persistent pan-Canadian increases in PO use, select control measures were implemented and PO dispensing levels—while only inconsistently by province—inverted, and began to plateau or decrease post-2012. We examined annual PO dispensing levels in Canada up until 2018, based on representative prescription sample data from community-based retail pharmacies. Annual prescription-based dispensing data were converted into defined daily doses/1000 population/day by province, and mainly categorized into ‘weak’ and ‘strong’ opioids. All provinces indicated decreasing trends in strong PO levels in most recent years, yet with inter-provincial differences of up to one magnitude in 2018; in about half the provinces, dispensing fell to below-2005 levels. British Columbia had the largest decline in strong PO dispensing from its peak rate (− 48.5%) in 2011. Weak opioid dispensing trends remained more inconsistent and bifurcated across Canada. The distinct effects of individual—including many provincially initiated and governed—PO control measures urgently need to be evaluated. In the meantime, recent reductions in general PO availability across Canada appear to have contributed to shortages in opioid supply for existent, sizable (including non-medical) user populations and may have contributed to recent marked increases in illicit opioid use and harms (including rising deaths).

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