Gerald Cochran1, Rebecca McCarthy2, Adam J Gordon3, Ralph E Tarter4. 1. University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA, 15260, USA; University of Pittsburgh, School of Medicine, M240 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: gcochran@pitt.edu. 2. VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15224, USA. Electronic address: Rebecca.Mccarthy@va.gov. 3. University of Utah, School of Medicine, 30 N. 1900 E Salt Lake City, UT 84132, USA; VA Salt Lake City Healthcare System, 500 Foothill Dr, Salt Lake City, UT 84148, USA. Electronic address: adam.gordon@hsc.utah.edu. 4. University of Pittsburgh, School of Pharmacy, 3501 Terrace St, Pittsburgh, PA 15213, USA. Electronic address: tarter@pitt.edu.
Abstract
BACKGROUND: Combining opioid medications and alcohol has serious implications for patient health, including overdose. Information regarding those who use/misuse opioid medications and engage in unhealthy alcohol use is limited to pharmacological and epidemiological descriptions. This study presents opioid medication misuse and behavioral, mental, and physical health characteristics of persons filling opioid medications that are engaged in unhealthy alcohol use. METHODS: We conducted a cross-sectional survey at 5 community pharmacies in Southwestern, Pennsylvania among patients filling opioid medications. Respondents completed validated opioid medication misuse, alcohol use, illicit drug use, depression, posttraumatic stress disorder (PTSD), and physical health functioning assessments. We present univariate and multivariate statistics describing opioid medication misuse and health risks among those positive for unhealthy alcohol use. RESULTS: A total of 344 patients completed the survey (75.8% response). A total of 15.9% of respondents screened positive for opioid medication misuse, of whom 20.3% reported unhealthy alcohol use. Taking opioid medications too often was reported among a larger proportion of the sample with unhealthy alcohol use (34.3%) compared to those without (22.1%, p=0.04). Further, among respondents with unhealthy alcohol use, illicit drug use (Adjusted odds ratio [AOR]=12.14, 95% Confidence Interval [CI]=1.64-89.72) and PTSD (AOR=9.77, 95% CI=1.70-56.11) were associated with increased odds for opioid medication misuse. CONCLUSION: Results suggest respondents with unhealthy alcohol use had distinct health profiles, which may place them at risk for opioid misuse and adverse events, such as overdose. Continued research must work to further understand these relationships and identify intervention and treatment strategies.
BACKGROUND: Combining opioid medications and alcohol has serious implications for patient health, including overdose. Information regarding those who use/misuse opioid medications and engage in unhealthy alcohol use is limited to pharmacological and epidemiological descriptions. This study presents opioid medication misuse and behavioral, mental, and physical health characteristics of persons filling opioid medications that are engaged in unhealthy alcohol use. METHODS: We conducted a cross-sectional survey at 5 community pharmacies in Southwestern, Pennsylvania among patients filling opioid medications. Respondents completed validated opioid medication misuse, alcohol use, illicit drug use, depression, posttraumatic stress disorder (PTSD), and physical health functioning assessments. We present univariate and multivariate statistics describing opioid medication misuse and health risks among those positive for unhealthy alcohol use. RESULTS: A total of 344 patients completed the survey (75.8% response). A total of 15.9% of respondents screened positive for opioid medication misuse, of whom 20.3% reported unhealthy alcohol use. Taking opioid medications too often was reported among a larger proportion of the sample with unhealthy alcohol use (34.3%) compared to those without (22.1%, p=0.04). Further, among respondents with unhealthy alcohol use, illicit drug use (Adjusted odds ratio [AOR]=12.14, 95% Confidence Interval [CI]=1.64-89.72) and PTSD (AOR=9.77, 95% CI=1.70-56.11) were associated with increased odds for opioid medication misuse. CONCLUSION: Results suggest respondents with unhealthy alcohol use had distinct health profiles, which may place them at risk for opioid misuse and adverse events, such as overdose. Continued research must work to further understand these relationships and identify intervention and treatment strategies.
Authors: Andrea Meier; Chantal Lambert-Harris; Mark P McGovern; Haiyi Xie; Melissa An; Bethany McLeman Journal: Am J Drug Alcohol Abuse Date: 2014-05-08 Impact factor: 3.829