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Associations among Pain, Non-Medical Prescription Opioid Use, and Drug Overdose History

Authors

  • Erin E. Bonar PhD,

    Corresponding author
    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
    • Address correspondence to Dr. Bonar, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109. E-mail: erinbona@med.umich.edu.

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  • Mark A. Ilgen PhD,

    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
    2. Veterans Affairs National Serious Mental Illness Treatment Research and Evaluation Center (SMITREC) and VA Health Services Research & Development, Ann Arbor, Michigan
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  • Maureen Walton MPH, PhD,

    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Amy S.B. Bohnert MHS, PhD

    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
    2. Veterans Affairs National Serious Mental Illness Treatment Research and Evaluation Center (SMITREC) and VA Health Services Research & Development, Ann Arbor, Michigan
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Abstract

Background and Objective

Recently, use of prescription opioids (POs) has increased; non-medical PO (NMPO) use is linked to overdose. NMPO use is common among individuals prescribed opioids for pain, and those in substance use disorder (SUD) treatment with pain could be at increased risk for unintentional overdose due to NMPO use. We examined associations between pain, NMPO use, and overdose among SUD treatment patients.

Methods

Among 342 patients at a residential SUD treatment center, logistic regression examined the association of overdose with pain, adjusting for substance use, suicide attempts, and demographics.

Results

Pain was positively related to NMPO use. Heroin use, suicide attempts, pain, and NMPO use were positively associated with overdose; but NMPO use attenuated the pain-overdose relationship.

Conclusions

The relationship between pain and overdose among substance users may be, in part, explained by the association between pain and heavy NMPO use. (Am J Addict 2014;23:41–47)

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