Epidemiological Trends in Abuse and Misuse of Prescription Opioids

ABSTRACT The authors evaluated trends between social, geographic, and demographic factors and cases of select scheduled drugs (buprenorphine, fentanyl, hydrocodone, hydromorphone, morphine, methadone, and oxycodone) using the Researched Abuse, Diversion and Addiction-Related Surveillance System poison center data and census data. Spontaneous calls from the public and healthcare professionals are recorded by poison centers using a standardized, electronic data collection system. We compared the annual incidence of total prescription opioid drug cases to annual data from the U.S. Department of Labor and U.S. Census Bureau by year and by state for unemployment rate, poverty rate, population density, high school graduation rate, and bachelor's degree proportion using the best least square fit in an evaluation for trends for 2003 to 2006. Two strong positive trends were found between poverty rate, unemployment rate, and prescription opioid drug rates, with prescription opioid drug rates increasing as poverty rate and unemployment rate increased. This trend was consistent over the 4 years of study and strongly influenced by the hydrocodone and methadone rates, with less influence from oxycodone rates. The high school graduation rate trend was consistent over the 4 years and was strongly influenced by the hydrocodone and methadone rate. No consistent trend was identified with population density and prescription opioid drug rates. Understanding trends may help guide distribution of scarce resources and prevention efforts to where they may have their greatest impact.