Mechanisms for prescription drug abuse in Appalachia: Preliminary data from inpatient prescription drug abusers

The rate of unintentional drug poisonings in West Virginia has risen 550% since 1999. The majority of the accidental poisonings are a result of prescription drug abuse; either from illegitimately obtained methadone or other opiates. Little is known about pathways and mechanisms to prescription drug use. We engaged in a qualitative study that yielded data necessary to inform a testable predictive model and possible prevention intervention approaches. We solicited and completed detailed interviews with 25 prescription drug abusers among the inpatient population at Chestnut Ridge Hospital, a psychiatric hospital in Morgantown, WV. All interviews were audio-taped, transcribed, coded and analyzed using qualitative data analytic software. Our data suggest mechanisms that are atypical from other substance abuse disorders. Specifically, somatic, legitimacy, economic and cultural constructs emerged. This study provides a multi-methodological and context-sensitive approach that enhances our understanding of the prescription drug abuse problem. It will ultimately aid in the development of locally relevant technologies of substance abuse behavior change.