Online Program

How does availability of prescription opioids affect pain reliever abuse at the county level? an ecological study in Indiana

Tuesday, November 5, 2013 : 1:10 p.m. - 1:30 p.m.

Eric R. Wright, PhD, IU Richard M. Fairbanks School of Public Health at IUPUI, Center for Health Policy, Indiana University-Purdue University Indianapolis, Indianapolis, IN
Marion S. Greene, MPH, Center for Health Policy, IU Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN
Background: Nonmedical prescription drug use has become an emerging public health problem in the United States. Particularly, pain relievers (opioids) have a high potential for abuse. Indiana's past-year prevalence rate for nonmedical pain reliever use was highest among young adults ages 18 to 25 (14.4%; 95% CI: 11.9-17.3) and surpassed the nation's rate (10.4%; 95% CI: 10.0-10.8). Research indicates that substance use may be linked to drug availability and social-environmental characteristics of the community. Methods: An ecological study to assess the impact of opioid availability and demographic characteristics on pain reliever abuse in Indiana was conducted; the county-level served as unit of analysis. We examined census information on gender, race, and age; INSPECT data (Indiana's prescription drug monitoring program) on the number of opioid prescriptions dispensed; and the Treatment Episode Data Set for prescription opioid abuse reported at treatment admission. Results: According to multiple linear regression analysis, our model (F4,87= 14.94, p<0.0001) was significant in predicting over 40% of the variance in pain reliever abuse. Conclusion: Use of prescription opioids is a legitimate treatment for many conditions. However, availability of these drugs and certain demographics may contribute to the increasing number of abuse. Raising awareness among healthcare professionals and policies encouraging routine use of INSPECT prior to prescribing scheduled substances may reduce the prevalence of abuse, dependence, and diversion. These findings are based on multiple linear regression analysis. Within the next few weeks, we will conduct additional spatial analyses to get a better understanding of the risk at the county-level.

Learning Areas:

Public health or related research

Learning Objectives:
List four social-environmental risk factors for pain reliever abuse Describe the relationship between availability of prescription drugs and nonmedical use Analyze patterns of pain reliever abuse in small areas using spatial statistics

Keyword(s): Prescription Drug Use Patterns, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a doctorate in sociology and nearly 20 years of experience conducting health services and policy research. I am currently the director of the Indiana State Epidemiology and Outcomes Workgroup, a scientific policy advisory board for the State of Indiana.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.