The 130th Annual Meeting of APHA

4092.0: Tuesday, November 12, 2002 - Board 5

Abstract #34845

Dependence on narcotic pain medication in people seeking detoxification: Magnitude of the problem and clinical correlates

Cynthia L. Arfken, PhD1, Norman S. Miller, MD2, and Charles R. Schuster, PhD1. (1) Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 2761 E. Jefferson, Detroit, MI 48201, (313) 993-3490,, (2) Psychiatry, Michigan State University, East Fee Hall, East Lansing, MI 48824

Narcotic pain medication prescriptions have increased markedly over the last decade with recent media attention focusing on their addiction potential, especially for oxycontin. The media reports appear to suggest narcotic pain medication addiction is more prevalent in nonurban, Midwestern areas containing large pockets of privately insured people. In this study, we examined dependence on narcotic pain medication in people seeking inpatient detoxification at a Midwestern hospital located in a medium sized city serving primarily private pay patients. For the year 2000, 27% of the 534 patients were dependent on at least one narcotic pain medication. Of those, 53% had a dependence on vicodin (schedule III medication) and 19% on oxycontin (schedule II medication). Patients with narcotic pain medication dependence were equally likely to suffer from multiple drug dependencies (83%), have additional psychiatric disorders (45%), and a history of previous addiction treatment (62%) as patients not dependent on narcotic pain medications. They were, however, less likely in multivariate analysis to have a current alcohol dependence (OR=0.20), arrest history (OR=0.54), and belong to a minority (OR=0.44). In contrast, they were more likely to have a medical problem (OR=3.47) and be younger (OR=0.96 per year). The analysis suggests dependence on narcotic pain medication is common in people seeking inpatient detoxification with a schedule III medication (vicodin) posing a greater problem than previously reported. In addition, clinical correlates suggest the need for primary care physicians to screen patients? psychiatric and drug abuse history and closely monitor behavior when prescribing narcotic pain medication.

Learning Objectives:

Keywords: Chemical Dependence, Drug Abuse

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Substance Abuse Treatment Strategies Poster Session

The 130th Annual Meeting of APHA