Smartest Doc
Denial of Prescription Opioids Among Young Adults with Histories of Opioid Misuse
Pain Medicine, 08/21/2012
Clinical Article
Fibbi M et al. - Being denied prescription opioids was an important moment in the drug using careers of many study participants. Results suggest that effective pain management techniques are needed to prevent high-risk young adults with pain problems from engaging in escalated opioid misuse and risk behaviors.
Methods- Ethno-epidemiological methodology utilizing a cross-sectional design, semi-structured interviews, and qualitative/quantitative data analysis.
- Non-clinical participants were recruited from natural settings, such as streets, parks, beaches, and college campuses, in New York City and Los Angeles during 2008 and 2009.
- One hundred fifty participants aged 16 to 25 who had misused a prescription opioid, tranquilizer, or stimulant in the past 90 days.
- Analyses focused on denial of opioids and associated consequences, including self-medication with prescription opioids and heroin.
- Thirty-four participants (22.7%) described being denied prescription opioids for the treatment of a painful condition.
- Current opioid misuse and current pain problems were higher in this group compared to those who had never been denied prescription opioids.
- Reasons for denial included being identified as a drug user by a physician, lack of health insurance, and having medication withheld by a parent or authority figure.
- Approximately half reported self-medicating pain with either illegally obtained prescription opioids or heroin.
- Self-medication often coincided with initiation of new risk behaviors and more intensive drug use.
