Nonmedical use of prescription opioids: furthering a meaningful research agenda.

UNLABELLED: The nonmedical use of prescription opioids (POs), and related harmful consequences, has increased in many populations in recent years in North America. Existing survey data are typically limited to descriptive prevalence statistics, and fail to examine important determinants or circumstances (including motives) of nonmedical PO use. We advocate that such analytical queries should become integral elements in future surveys. Developing the needed survey items, however, requires conceptual thoughtfulness and rigor, especially given POs' potential for both therapeutic (eg, analgesic) effects and abuse. These considerations are concretely relevant for possible "self-medicating" nonmedical usage of POs as well as with regards to varying definitions of "pain." Furthermore, we support the harmonization of survey items on nonmedical PO use to allow for cross-national comparisons, yet also call for cross-cultural examinations into the determinants of the currently vastly discrepant medical and nonmedical PO use rates across Western countries. PERSPECTIVE: We support Zacny and Lichtor's call for systematic examination of motives presented by individuals engaging in nonmedical prescription opioid use. Such motives could relate to factors instrinsic or extrinsic to the user, yet their understanding is crucial for the devising of evidence-based interventions.