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Sources of prescription opioids among diagnosed opioid abusers.
Curr Med Res Opin. 2015 Apr; 31(4):779-84.CM

Abstract

OBJECTIVE

Diversion and abuse of prescription opioids are important public health concerns in the US. This study examined possible sources of prescription opioids among patients diagnosed with opioid abuse.

METHODS

Commercially insured patients aged 12-64 diagnosed with opioid abuse/dependence ('abuse') were identified in OptumHealth Reporting and Insights medical and pharmacy claims data, 2006-2012, and required to have continuous eligibility over an 18 month study period surrounding the first abuse diagnosis. We examined whether abusers had access to prescription opioids through their own prescriptions and/or to diverted prescription opioids through family members' prescriptions obtained prior to the abuser's first abuse diagnosis. For comparison, we examined access to prescription opioids of a reference population of non-abusers. Sensitivity analyses focused on patients initially diagnosed with opioid dependence and, separately, abusers not previously treated with buprenorphine.

RESULTS

Of the 9291 abusers meeting the selection criteria, 79.9% had an opioid prescription prior to their first abuse diagnosis; 20.1% of abusers did not have an opioid prescription prior to their first abuse diagnosis, of whom approximately half (50.8%) had a family member who had an opioid prescription prior to the abuser's first abuse diagnosis (compared to 42.2% of non-abusers). Similar results were found among patients initially diagnosed with opioid dependence and among abusers not previously treated with buprenorphine.

LIMITATIONS

The study relied on the accuracy of claims data to identify abusers, but opioid abuse is often undiagnosed. In addition, only prescription claims that were reimbursed by a health plan were included in the analysis.

CONCLUSIONS

While most abusers had access to prescription opioids through their own prescriptions, many abusers without their own opioid prescriptions had access to prescription opioids through family members and may have obtained prescription opioids that way. Given the study design and data source, this is likely a conservative estimate of prescription opioid diversion.

Authors+Show Affiliations

Analysis Group Inc. , Boston, MA , USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25661018

Citation

Shei, Amie, et al. "Sources of Prescription Opioids Among Diagnosed Opioid Abusers." Current Medical Research and Opinion, vol. 31, no. 4, 2015, pp. 779-84.
Shei A, Rice JB, Kirson NY, et al. Sources of prescription opioids among diagnosed opioid abusers. Curr Med Res Opin. 2015;31(4):779-84.
Shei, A., Rice, J. B., Kirson, N. Y., Bodnar, K., Birnbaum, H. G., Holly, P., & Ben-Joseph, R. (2015). Sources of prescription opioids among diagnosed opioid abusers. Current Medical Research and Opinion, 31(4), 779-84. https://doi.org/10.1185/03007995.2015.1016607
Shei A, et al. Sources of Prescription Opioids Among Diagnosed Opioid Abusers. Curr Med Res Opin. 2015;31(4):779-84. PubMed PMID: 25661018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sources of prescription opioids among diagnosed opioid abusers. AU - Shei,Amie, AU - Rice,J Bradford, AU - Kirson,Noam Y, AU - Bodnar,Katharine, AU - Birnbaum,Howard G, AU - Holly,Pamela, AU - Ben-Joseph,Rami, Y1 - 2015/02/24/ PY - 2015/2/10/entrez PY - 2015/2/11/pubmed PY - 2015/9/19/medline KW - Abuse KW - Diversion KW - Opioid analgesics SP - 779 EP - 84 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 31 IS - 4 N2 - OBJECTIVE: Diversion and abuse of prescription opioids are important public health concerns in the US. This study examined possible sources of prescription opioids among patients diagnosed with opioid abuse. METHODS: Commercially insured patients aged 12-64 diagnosed with opioid abuse/dependence ('abuse') were identified in OptumHealth Reporting and Insights medical and pharmacy claims data, 2006-2012, and required to have continuous eligibility over an 18 month study period surrounding the first abuse diagnosis. We examined whether abusers had access to prescription opioids through their own prescriptions and/or to diverted prescription opioids through family members' prescriptions obtained prior to the abuser's first abuse diagnosis. For comparison, we examined access to prescription opioids of a reference population of non-abusers. Sensitivity analyses focused on patients initially diagnosed with opioid dependence and, separately, abusers not previously treated with buprenorphine. RESULTS: Of the 9291 abusers meeting the selection criteria, 79.9% had an opioid prescription prior to their first abuse diagnosis; 20.1% of abusers did not have an opioid prescription prior to their first abuse diagnosis, of whom approximately half (50.8%) had a family member who had an opioid prescription prior to the abuser's first abuse diagnosis (compared to 42.2% of non-abusers). Similar results were found among patients initially diagnosed with opioid dependence and among abusers not previously treated with buprenorphine. LIMITATIONS: The study relied on the accuracy of claims data to identify abusers, but opioid abuse is often undiagnosed. In addition, only prescription claims that were reimbursed by a health plan were included in the analysis. CONCLUSIONS: While most abusers had access to prescription opioids through their own prescriptions, many abusers without their own opioid prescriptions had access to prescription opioids through family members and may have obtained prescription opioids that way. Given the study design and data source, this is likely a conservative estimate of prescription opioid diversion. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/25661018/Sources_of_prescription_opioids_among_diagnosed_opioid_abusers_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007995.2015.1016607 DB - PRIME DP - Unbound Medicine ER -