Adults in a residential addiction treatment center had high rates of prescription opioid use for reasons other than pain relief, according to a recent article in Clinical Psychiatry News referencing a study published in Addictive Behaviors. The study involved 351 patients. Alcohol was the primary substance for seeking treatment (30%) followed by heroin (19%), cocaine (16%), marijuana (10%), and other opiates (4%). 21% were listed as “other/missing.”

Overall, 238 patients, or 68% of the total cohort, reported using prescription opioids in the prior month for reasons other than pain relief, such as to get high or relax, compared with 34% who were motivated to use opioids only for pain relief.

Patients who used opioids for other than pain relief were significantly more likely to be female, white, and have a history of overdose. The average age of the cohort was 35.6 years, which puts them in an age group at high risk for opioid overdose. These adults also had more established patterns of substance abuse, averaging 10.8 years of regular alcohol abuse, 8 years of cocaine abuse, and 6 years of heroin abuse.

Respondents who used opioids for reasons other than pain relief were more likely to be heavy opiate users and to have used barbiturates, other sedatives, and heroin in the past 30 days.

Although current suicidal ideation was similar between groups, overall mental health and depressive symptoms were more common in the group using opiates for nonmedical purposes, suggesting they had poorer mental health.

The authors concluded that the high rate of nonmedical opioid use observed in the sample “may signal an emerging and potentially critical issue in addiction treatment programs.”

An older MTF (Monitoring the Future) study among high school seniors in the U.S., showed 12% reported lifetime nonmedical use of prescription opioids and 8% reported past-year nonmedical use.

The leading motives included “to relax or relieve tension” (56%), “to feel good or get high” (53%), “to experiment, see what it is like” (52%), “to relieve physical pain” (45%), and “to have a good time with friends” (29%).

Both studies concluded that reasons and motives for nonmedical opioid use need to be examined to develop treatment plans for the users.

Andrew Deckert, MD                                                                                                       Public Health Officer                                                                                                                                Shasta County

Wendling, P.,(2013), Motives for Nonmedical Opioid Use Examined, Clinical Psychiatry News, 8/29/13.

Bohnert,A.S, et al, (2013), Addict.Behav. 2013:38:1776-81.

McCabe, S.E., et al, (2009), ArchPedi. jamanetwork.com.