Intentional Abuse of Select Opioids Reported to a Single Poison Center

Objective:   The purpose of this study was to characterize the epidemiological trends in intentional abuse of select prescription opioids reported to a single poison center (PC) that serves a predominantly rural population.

Methods:   The PC database was queried for patients >=13 years between calendar years (CY) 2009-2013 for the following opioids: buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, tapentadol, and tramadol.  Demographic, geographical, exposure, and clinical characteristics were assessed.  

Results:  A total of 2,868 intentional exposures were identified, of which hydrocodone (35.2%), oxycodone (23.5%), and tramadol (18.8%) were most frequently abused.  While the distribution by gender was similar in 13-19 year and 20-39 year age groups, women accounted for 60.8% and 67.5% of intentional exposures in those 40-59 and >=60 years of age, respectively.  Between 2009 and 2013, the greatest change was identified in those 40-59 and >=60 years of age with increases of 57.4% and 77.4%, respectively.  Most patients were either in/en-route to a healthcare facility (83.4%) or referred to one by the PC (13.3%) due to the exposure.

Discussion:  While the overall call volume showed a slight increase with 16.4 additional exposures per year, the rates were greatest in women ages 40-59 (11.9 increased exposures/month).  Continued surveillance of epidemiological trends of intentional opioid medications abuse through PC data may provide insight into at risk populations for intentional overdose.