Gerald Cochran1, Elizabeth Charron2, Jennifer L Brown3, Alina Cernasev4, Kenneth C Hohmeier5, T John Winhusen6. 1. University of Utah, Department of Internal Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, USA. Electronic address: jerry.cochran@hsc.utah.edu. 2. University of Utah, Department of Internal Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, USA. Electronic address: betsy.charron@utah.edu. 3. University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience, 260 Stetson Street, Cincinnati, OH 45267-0559, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA. Electronic address: brown5j8@ucmail.uc.edu. 4. University of Tennessee, Nashville, College of Pharmacy, 301 S Perimeter Park Dr, Nashville, TN 37211, USA. Electronic address: acernase@uthsc.edu. 5. University of Tennessee, Nashville, College of Pharmacy, 301 S Perimeter Park Dr, Nashville, TN 37211, USA. Electronic address: khohmeie@uthsc.edu. 6. University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience, 260 Stetson Street, Cincinnati, OH 45267-0559, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA. Electronic address: winhust@ucmail.uc.edu.
Abstract
BACKGROUND: Included among the significant risk factors for opioid overdose is concomitant use of other central nervous system depressants, particularly alcohol. Given the continued expansion of community pharmacy in the continuum of care, it is imperative to characterize alcohol use among pharmacy patients dispensed opioids in order to establish a foundation for identification and intervention in these settings. METHODS: This secondary analysis utilized data from a one-time, cross-sectional health assessment conducted among patients dispensed opioid medications in 19 community pharmacies in Indiana and Ohio. Adult, English speaking, patients not receiving cancer care who were dispensed opioid medications were asked to self-report alcohol and substance use, behavioral and physical health, and demographic information. Descriptive and logistic regression analyses were employed to characterize alcohol use/risky alcohol use and patient characteristics associated therewith. RESULTS: The analytical sample included 1494 individuals. Participants were on average 49 years of age (Standard Deviation=14.9)-with 6% being persons of color (n = 89). Weekly drinking was reported by 18.1% (n = 204) and daily drinking was reported by 6.8% (n = 77) of the study sample, with a total of 143 (9.6%) participants reporting moderate/high risk drinking. Males (Adjusted Odds Ratio [AOR]=1.94, 95% CI=1.3,2.9), those with higher pain interference (AOR=1.44, 95% CI=1.0,2.0), overdose history (AOR=1.93, 95% CI=1.1,3.5), sedative use (AOR=2.11, 95% CI=1.3,3.5), and tobacco use (AOR=2.41, 95% CI=1.6,3.7) had increased likelihood of moderate/high risk alcohol use (all p < 0.05). CONCLUSIONS: Medication labeling and clinical guidelines clearly indicate that patients should abstain from concomitant use of opioids and alcohol. This study has identified rates and associated risk factors of risky alcohol use among a clinical sample of community pharmacy patients dispensed opioid medications. Continuing this line of research and potential clinical service development has the ability to improve patient safety through addressing a significant gap within the current opioid epidemic.
BACKGROUND: Included among the significant risk factors for opioid overdose is concomitant use of other central nervous system depressants, particularly alcohol. Given the continued expansion of community pharmacy in the continuum of care, it is imperative to characterize alcohol use among pharmacy patients dispensed opioids in order to establish a foundation for identification and intervention in these settings. METHODS: This secondary analysis utilized data from a one-time, cross-sectional health assessment conducted among patients dispensed opioid medications in 19 community pharmacies in Indiana and Ohio. Adult, English speaking, patients not receiving cancer care who were dispensed opioid medications were asked to self-report alcohol and substance use, behavioral and physical health, and demographic information. Descriptive and logistic regression analyses were employed to characterize alcohol use/risky alcohol use and patient characteristics associated therewith. RESULTS: The analytical sample included 1494 individuals. Participants were on average 49 years of age (Standard Deviation=14.9)-with 6% being persons of color (n = 89). Weekly drinking was reported by 18.1% (n = 204) and daily drinking was reported by 6.8% (n = 77) of the study sample, with a total of 143 (9.6%) participants reporting moderate/high risk drinking. Males (Adjusted Odds Ratio [AOR]=1.94, 95% CI=1.3,2.9), those with higher pain interference (AOR=1.44, 95% CI=1.0,2.0), overdose history (AOR=1.93, 95% CI=1.1,3.5), sedative use (AOR=2.11, 95% CI=1.3,3.5), and tobacco use (AOR=2.41, 95% CI=1.6,3.7) had increased likelihood of moderate/high risk alcohol use (all p < 0.05). CONCLUSIONS: Medication labeling and clinical guidelines clearly indicate that patients should abstain from concomitant use of opioids and alcohol. This study has identified rates and associated risk factors of risky alcohol use among a clinical sample of community pharmacy patients dispensed opioid medications. Continuing this line of research and potential clinical service development has the ability to improve patient safety through addressing a significant gap within the current opioid epidemic.
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