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Prescribed Opioids as an Initial Exposure in Emergency Department Patients Reporting Nonmedical Opioid or Heroin Use

Ancona, Rachel M
http://orcid.org/0000-0001-6514-0897
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459244023

Abstract Details

2016, MS, University of Cincinnati, Medicine: Epidemiology (Environmental Health).
The problem of prescription opioid pain reliever misuse and abuse has become a critical public health issue in the United States. Current public health efforts include monitoring patients on courses of opioid pain therapy, treatment interventions for those who are already abusing or misusing opioids, prescription drug monitoring programs aimed at reducing misuse and diversion, and Naloxone distribution programs to save the lives of those who overdose. To date, there has been little definitive research on prescribed opioids as an initial exposure preceding opioid abuse. This study examined the proportion of emergency department patients with a history of opioid abuse who reported their initial exposure as medical (prescribed to them by their doctor for a medical purpose) and, if so reported, how many of those initial prescriptions came from an emergency department (ED). In this cross-sectional study design, ED patients who self-reported nonmedical opioid use were surveyed about their initial opioid exposure, non-opioid substance use prior to initial opioid exposure, and subsequent opioid use including time from initial exposure to nonmedical use. From 59 enrolled subjects, 35 reported their initial opioid exposure as medical (35/59; 59%; 95% confidence interval [CI] 47% to 71%), and of these, 10 reported their initial exposure was from an emergency department (10/35; 29%; 95% CI 16% to 45%). Thirty-one of the 35 medically exposed subjects reported that time from initial exposure to onset of nonmedical use, with a median time from initial medical exposure to onset of nonmedical use was 12 months (interquartile range [IQR] 2 to 36). Most medically exposed subjects (28/35; 80%; 95% CI 65% to 91%) reported non-opioid substance use (illicit substance use) or treatment for non-opioid substance use (alcohol or illicit substance use) prior to, or at the time of, their initial medical exposure. Medically exposed subjects were similar in characteristics, in their non-opioid substance use prior to initial exposure, and subsequent intravenous drug use and opioid overdose. While this preliminary study has a limited sample size and its results are not definitive, the high proportion reporting their initial opioid exposure as medical, and the short time from that initial medical exposure to onset of nonmedical opioid use, the results support future research into legitimate medical prescriptions as an exposure contributing to incident cases of opioid abuse.
Kim Dietrich, Ph.D. (Committee Chair)
Michael Lyons, M.D. M.P.H. (Committee Member)
Marepalli Rao, Ph.D. (Committee Member)
25 p.
Epidemiology
prescription drugs; opioids; emergency department; heroin; overdose

Recommended Citations

Citations

  • Ancona, R. M. (2016). Prescribed Opioids as an Initial Exposure in Emergency Department Patients Reporting Nonmedical Opioid or Heroin Use [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459244023

    APA Style (7th edition)

  • Ancona, Rachel. Prescribed Opioids as an Initial Exposure in Emergency Department Patients Reporting Nonmedical Opioid or Heroin Use. 2016. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459244023.

    MLA Style (8th edition)

  • Ancona, Rachel. "Prescribed Opioids as an Initial Exposure in Emergency Department Patients Reporting Nonmedical Opioid or Heroin Use." Master's thesis, University of Cincinnati, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459244023

    Chicago Manual of Style (17th edition)

ucin1459244023
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This open access ETD is published by University of Cincinnati and OhioLINK.