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Opioid Abuse (opioid + abuse)
Selected AbstractsRisk factors for drug dependence among out-patients on opioid therapy in a large US health-care systemADDICTION, Issue 10 2010Joseph A. Boscarino ABSTRACT Aims Our study sought to assess the prevalence of and risk factors for opioid drug dependence among out-patients on long-term opioid therapy in a large health-care system. Methods Using electronic health records, we identified out-patients receiving 4+ physician orders for opioid therapy in the past 12 months for non-cancer pain within a large US health-care system. We completed diagnostic interviews with 705 of these patients to identify opioid use disorders and assess risk factors. Results Preliminary analyses suggested that current opioid dependence might be as high as 26% [95% confidence interval (CI) = 22.0,29.9] among the patients studied. Logistic regressions indicated that current dependence was associated with variables often in the medical record, including age <65 [odds ratio (OR) = 2.33, P = 0.001], opioid abuse history (OR = 3.81, P < 0.001), high dependence severity (OR = 1.85, P = 0.001), major depression (OR = 1.29, P = 0.022) and psychotropic medication use (OR = 1.73, P = 0.006). Four variables combined (age, depression, psychotropic medications and pain impairment) predicted increased risk for current dependence, compared to those without these factors (OR = 8.01, P < 0.001). Knowing that the patient also had a history of severe dependence and opioid abuse increased this risk substantially (OR = 56.36, P < 0.001). Conclusion Opioid misuse and dependence among prescription opioid patients in the United States may be higher than expected. A small number of factors, many documented in the medical record, predicted opioid dependence among the out-patients studied. These preliminary findings should be useful in future research efforts. [source] Commentary on Boscarino et al. (2010): Understanding the spectrum of opioid abuse, misuse and harms among chronic opioid therapy patientsADDICTION, Issue 10 2010MICHAEL VON KORFF No abstract is available for this article. [source] CLINICAL STUDY: Alterations in pituitary-thyroid axis function among opioid-dependent subjects after acute and protracted abstinenceADDICTION BIOLOGY, Issue 3 2009Guo-fu Zhang ABSTRACT The aim of the present study was to investigate the changes in the pituitary-thyroid axis (PTA) and the time course of the hormonal alterations in subjects with opioid dependence after abstinence. Blood samples from in-patients with opioid dependence and age- and sex-matched healthy controls were collected. The severity of opioid abuse and of withdrawal symptoms was assessed. Results were compared between patients with opioid dependence (n = 30) and healthy controls (n = 30). We found that free triiodothyronine and free thyroxine levels were comparable with healthy controls while thyroid-stimulating hormone (TSH) was lower in patients in acute opioid abstinence period. Also, TSH levels in patients remained lower than controls after 30 days of abstinence. These results indicate that PTA function is altered in opioid-dependent subjects. These data highlight the importance of screening the thyroid function for individuals with chronic opioid dependence. [source] Analysis of opium use by students of medical sciencesJOURNAL OF CLINICAL NURSING, Issue 4 2006Jamshid Ahmadi MD Aims and objectives., To investigate the prevalence of opium use in university students. Background., University health professionals and authorities are very concerned about substance use among university students. Design., A survey with a representative sample of 2519 (1126 men and 1393 women) university students and opium use disorders assessed by means of DSM-IV criteria (Diagnostic Statistical Manual-IV Axis I during the year 2003). Findings., Mean age of the sample was 23·8 year and SD was 3·9. Of the students, 110 (4·4%) admitted using of opium once or more during their lives (9.1% of men and 0·6% of women; P < 0·01). Fifty (2%) were occasional opium user (4·2% of men and 0·2% of women; P < 0·01). Nineteen (0·8%) were current opium user (1·4% of men and 0·2% of women; P = 0·001). Mean age of opium users was higher than the remainder. Opium use was significantly related to gender (P = 0·001), and life stress (P = 0·04). Conclusion., These findings can be considered for preventive and therapeutic programmes, because early intervention during the formative university years may present an opportunity to reduce the risk of long-term problems, to decrease social and individual harm and also to promote public health of society. Relevance to clinical practice., These findings can be considered in clinical practice for detection and treatment of opioid abuse. [source] Integrating nine prescription opioid analgesics and/or four signal detection systems to summarize statewide prescription drug abuse in the United States in 2007,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2009Michael F. Schneider MS Abstract Purpose Integrate statewide rankings of abuse across different drugs and/or signal detection systems to summarize prescription drug abuse in each state in 2007. Methods Four signal detection systems (Opioid Treatment Programs, Key Informants, Drug Diversion, and Poison Centers) that covered heterogeneous populations collected data on the abuse of nine opioids: hydrocodone, immediate-release oxycodone, tramadol, extended-release [ER] oxycodone, fentanyl, morphine, methadone, hydromorphone, and buprenorphine). We introduce here linearized maps which integrate nine drugs within each system; four systems for each drug; or all drugs and systems. Results When rankings were integrated across drugs, Rhode Island, New Hampshire, Maine, West Virginia, and Michigan were in the highest tertile of abuse in three systems. When rankings were integrated across signal detection systems, there was a geographic clustering of states with the highest rates for ER oxycodone (in Tennessee, Mississippi, Kentucky, Ohio, Indiana, Michigan, and in Massachusetts, New Hampshire, Maine, and Vermont) and methadone (Massachusetts, Rhode Island, New Hampshire, Maine, Vermont, Connecticut, and New Jersey). When rankings were integrated across both drugs and signal detection systems, states with 3-digit ZIP codes below 269 (i.e., from Massachusetts to West Virginia): Massachusetts, New Hampshire, Maine, Vermont, Washington DC, Virginia, and West Virginia were in the highest tertile and only Delaware was in the lowest tertile. Conclusions We have presented methods to integrate data on prescription opioid abuse collected by signal detection systems covering different populations. Linearized maps are effective graphical summaries that depict differences in the level of prescription opioid abuse at the state level. Copyright © 2009 John Wiley & Sons, Ltd. [source] Characterizing the Emerging Population of Prescription Opioid AbusersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2006Stacey C. Sigmon PhD Despite an alarming recent increase in prescription opioid abuse, the characteristics of prescription opioid abusers remain largely unknown. In this study, the demographic and drug use characteristics of 75 methadone patients (36 prescription opioid and 39 heroin users) were compared using a retrospective chart review. Prescription opioid abusers exhibited a profile of characteristics that may predict favorable treatment response, including less severe opioid use and IV drug use, and greater social stability compared to primary heroin abusers. Despite the limitations inherent in this retrospective chart review, this study provides initial evidence that prescription opioid abusers may have a number of characteristics that predict favorable treatment response. This new information may inform and assist current efforts to develop efficacious treatments for prescription opioid abuse. [source] | ||||||||||