Measures to quantify the abuse of prescription opioids: a review of data sources and metrics

The abuse and nonmedical use of prescription opioids and its subsequent consequences are an important public health concern. This phenomenon has paralleled the increase in the therapeutic use of opioids for pain management. There is thus a need to measure prescription opioid abuse to understand trends over time and to compare abuse of one product to another. The purpose of this review is to provide an overview of the strengths and weaknesses of frequently used numerators and denominators in “abuse ratios” (ARs).

[1]  A. Muñoz,et al.  Relationship between therapeutic use and abuse of opioid analgesics in rural, suburban, and urban locations in the United States , 2007, Pharmacoepidemiology and drug safety.

[2]  J. Benneyan,et al.  National addictions vigilance intervention and prevention program (NAVIPPRO™): a real‐time, product‐specific, public health surveillance system for monitoring prescription drug abuse , 2008, Pharmacoepidemiology and drug safety.

[3]  L. Manchikanti,et al.  Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective. , 2010, Pain physician.

[4]  Richard C Dart,et al.  The development of a comprehensive risk-management program for prescription opioid analgesics: researched abuse, diversion and addiction-related surveillance (RADARS). , 2007, Pain medicine.

[5]  B. Harrison Prescription drug monitoring programs. , 2006, NCSL legisbrief.

[6]  M Soledad Cepeda,et al.  Opioid Shopping Behavior: How Often, How Soon, Which Drugs, and What Payment Method , 2013, Journal of clinical pharmacology.

[7]  A. Muñoz,et al.  An independent assessment of MEDWatch reporting for abuse/dependence and withdrawal from Ultram (tramadol hydrochloride). , 2003, Drug and alcohol dependence.

[8]  M Soledad Cepeda,et al.  Assessing Opioid Shopping Behaviour , 2012, Drug Safety.

[9]  J. Benneyan,et al.  Illustration of a Statistical Process Control Approach to Regional Prescription Opioid Abuse Surveillance , 2011, Journal of addiction medicine.

[10]  P A Chyka,et al.  Poisoning mortality in the United States: comparison of national mortality statistics and poison control center reports. , 2000, Annals of emergency medicine.

[11]  Maria A. Levi-Minzi,et al.  Multiple Determinants of Specific Modes of Prescription Opioid Diversion , 2011, Journal of drug issues.

[12]  N. Dasgupta,et al.  OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION Original Research Article Post-marketing Surveillance of Methadone and Buprenorphine in the United States , 2010 .

[13]  Bradley C. Martin,et al.  Trends in use of opioids for non-cancer pain conditions 2000–2005 in Commercial and Medicaid insurance plans: The TROUP study , 2008, PAIN.

[14]  H. Birnbaum,et al.  Volume of Prescription Opioids Used Nonmedically in the United States , 2010, Journal of pain & palliative care pharmacotherapy.

[15]  Matt Schiller,et al.  Analytic models to identify patients at risk for prescription opioid abuse. , 2009, The American journal of managed care.

[16]  W. Ling,et al.  Prescription opioid abuse, pain and addiction: clinical issues and implications. , 2011, Drug and alcohol review.

[17]  Meredith Y. Smith,et al.  Risk identification, risk assessment, and risk management of abusable drug formulations. , 2006, Drug and alcohol dependence.

[18]  J. Inciardi,et al.  Trends in the use and abuse of branded and generic extended release oxycodone and fentanyl products in the United States. , 2007, Drug and alcohol dependence.

[19]  Wing Chow,et al.  A Large Cohort Study from a Medication Dispensing Database in the US , 2012 .

[20]  Nabarun Dasgupta,et al.  Association between non-medical and prescriptive usage of opioids. , 2006, Drug and alcohol dependence.

[21]  Hrishikesh Kale,et al.  Changes in oxycodone and heroin exposures in the National Poison Data System after introduction of extended-release oxycodone with abuse-deterrent characteristics , 2013, Pharmacoepidemiology and drug safety.

[22]  Jeanmarie Perrone,et al.  Can prescription drug monitoring programs help limit opioid abuse? , 2011, JAMA.

[23]  A. Muñoz,et al.  Rates of abuse of tramadol remain unchanged with the introduction of new branded and generic products: results of an abuse monitoring system, 1994–2004 , 2005, Pharmacoepidemiology and drug safety.

[24]  N. Volkow,et al.  Abuse of prescription drugs and the risk of addiction. , 2006, Drug and alcohol dependence.

[25]  Michael J Smith,et al.  Doctor and Pharmacy Shopping for Controlled Substances , 2012, Medical care.

[26]  C. Arfken,et al.  Postmarketing surveillance for drug abuse. , 2003, Drug and alcohol dependence.

[27]  W. Compton,et al.  Developments in the epidemiology of drug use and drug use disorders. , 2005, The American journal of psychiatry.

[28]  L. Paulozzi,et al.  Emergency department visits involving nonmedical use of selected prescription drugs - United States, 2004-2008. , 2010, MMWR. Morbidity and mortality weekly report.

[29]  B. Bégaud,et al.  Is reporting rate a good predictor of risks associated with drugs? , 1999, British journal of clinical pharmacology.

[30]  J A Inciardi,et al.  A postmarketing surveillance program to monitor Ultram (tramadol hydrochloride) abuse in the United States. , 1999, Drug and alcohol dependence.

[31]  B. Anderson,et al.  Potential for erroneous interpretation of poisoning outcomes due to changes in National Poison Data System reporting , 2010, Clinical toxicology.

[32]  P. DasMahapatra,et al.  Changes in prevalence of prescription opioid abuse after introduction of an abuse-deterrent opioid formulation. , 2014, Pain medicine.

[33]  S. Schnoll,et al.  Do prescription monitoring programs impact state trends in opioid abuse/misuse? , 2012, Pain medicine.

[34]  S. Fishman,et al.  An analysis of the number of multiple prescribers for opioids utilizing data from the California Prescription Monitoring Program , 2011, Pharmacoepidemiology and drug safety.

[35]  S. Butler,et al.  Abuse rates and routes of administration of reformulated extended-release oxycodone: initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment. , 2013, The journal of pain : official journal of the American Pain Society.

[36]  J. Davis,et al.  Reduced abuse, therapeutic errors, and diversion following reformulation of extended-release oxycodone in 2010. , 2013, The journal of pain : official journal of the American Pain Society.

[37]  P. Barton,et al.  The effect of FDA approval of a generic competitor to OxyContin (oxycodone HCl controlled-release) tablets on the abuse of oxycodone. , 2006, Drug and alcohol dependence.

[38]  S. Walsh,et al.  The relative abuse liability of oral oxycodone, hydrocodone and hydromorphone assessed in prescription opioid abusers. , 2008, Drug and alcohol dependence.

[39]  D J Graham,et al.  The role of databases in drug postmarketing surveillance , 2001, Pharmacoepidemiology and drug safety.

[40]  Meelee Kim,et al.  Usefulness of prescription monitoring programs for surveillance—analysis of Schedule II opioid prescription data in Massachusetts, 1996–2006 , 2010, Pharmacoepidemiology and drug safety.

[41]  S. Butler,et al.  Abuse risks and routes of administration of different prescription opioid compounds and formulations , 2011, Harm reduction journal.

[42]  S. Goldman,et al.  Limitations and strengths of spontaneous reports data. , 1998, Clinical therapeutics.

[43]  R. Dart,et al.  Active surveillance of abused and misused prescription opioids using poison center data: A pilot study and descriptive comparison , 2007, Clinical toxicology.

[44]  Hilary N. Homenko Rehabilitating opioid regulation: a prescription for the FDA's next proposal of an opioid risk evaluation and mitigation strategy (REMS). , 2012, Health matrix.

[45]  G. Woody,et al.  Nonmedical use and abuse of scheduled medications prescribed for pain, pain-related symptoms, and psychiatric disorders: Patterns, user characteristics, and management options , 2005, Current psychiatry reports.

[46]  R. C. Nelson,et al.  The impact of the addition of naloxone on the use and abuse of pentazocine. , 1987, Public health reports.

[47]  Meredith Y. Smith,et al.  Quantifying morbidity associated with the abuse and misuse of opioid analgesics: A comparison of two approaches , 2007, Clinical toxicology.

[48]  K. Foley,et al.  College on Problems of Drug Dependence taskforce on prescription opioid non-medical use and abuse: position statement. , 2003, Drug and alcohol dependence.

[49]  Yongli Xi,et al.  Increasing deaths from opioid analgesics in the United States , 2006, Pharmacoepidemiology and drug safety.

[50]  Christopher M. Jones,et al.  Vital signs: risk for overdose from methadone used for pain relief - United States, 1999-2010. , 2012, MMWR. Morbidity and mortality weekly report.

[51]  D. Spyker,et al.  2010 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 28th Annual Report , 2011, Clinical toxicology.

[52]  W. Irish,et al.  Detecting signals of opioid analgesic abuse: application of a spatial mixed effect poisson regression model using data from a network of poison control centers , 2008, Pharmacoepidemiology and drug safety.