Assessment of risk behaviors in patients with opioid prescriptions: A study of indiana's inspect data

Marion S. Greene, R. Chambers, Constantin Yiannoutsos, Eric R. Wright, Gregory K. Steele, Terrell W. Zollinger

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients’ likelihood to engage in opioid-related risk behaviors. Methods: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines. Two binary logistic regression analyses (engaging in at least one risk behaviors; engaging in all four risk behaviors) and an ordinal regression analysis (engaging in 0–4 risk behaviors) were conducted to identify factors associated with these opioid-related risk behaviors. Results: Of the 1,538,120 unique opioid patients included in the study, 18.4% engaged in one, 5.3% in two, 1.6% in three, and.4% in all four risk behaviors. Depending on the model, prescribing a second monthly opioid increased patients’ odds to engage in risk behaviors by a factor of 10 or more and prescribing two or more benzodiazepines annually increased the odds at least 13-fold. Conclusions and Scientific Significance: About one-fourth of all patients consuming opioids engaged in one or more risk behaviors; higher number of opioid prescriptions and addition of even a small number of benzodiazepine prescriptions dramatically increased these odds. PDMPs can be helpful in identifying opioid users at high-risk for misuse. This information could be used to target efforts to reduce the prescription drug epidemic. (Am J Addict 2017;26:822–829).

Original languageEnglish (US)
Pages (from-to)822-829
Number of pages8
JournalAmerican Journal on Addictions
Volume26
Issue number8
DOIs
StatePublished - Dec 1 2017

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Risk-Taking
Opioid Analgesics
Prescriptions
Prescription Drugs
Drug Monitoring
Benzodiazepines
Regression Analysis
Pharmacies
Morphine
Logistic Models

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Assessment of risk behaviors in patients with opioid prescriptions : A study of indiana's inspect data. / Greene, Marion S.; Chambers, R.; Yiannoutsos, Constantin; Wright, Eric R.; Steele, Gregory K.; Zollinger, Terrell W.

In: American Journal on Addictions, Vol. 26, No. 8, 01.12.2017, p. 822-829.

Research output: Contribution to journalArticle

Greene, Marion S. ; Chambers, R. ; Yiannoutsos, Constantin ; Wright, Eric R. ; Steele, Gregory K. ; Zollinger, Terrell W. / Assessment of risk behaviors in patients with opioid prescriptions : A study of indiana's inspect data. In: American Journal on Addictions. 2017 ; Vol. 26, No. 8. pp. 822-829.
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abstract = "Background and Objectives: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients’ likelihood to engage in opioid-related risk behaviors. Methods: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines. Two binary logistic regression analyses (engaging in at least one risk behaviors; engaging in all four risk behaviors) and an ordinal regression analysis (engaging in 0–4 risk behaviors) were conducted to identify factors associated with these opioid-related risk behaviors. Results: Of the 1,538,120 unique opioid patients included in the study, 18.4{\%} engaged in one, 5.3{\%} in two, 1.6{\%} in three, and.4{\%} in all four risk behaviors. Depending on the model, prescribing a second monthly opioid increased patients’ odds to engage in risk behaviors by a factor of 10 or more and prescribing two or more benzodiazepines annually increased the odds at least 13-fold. Conclusions and Scientific Significance: About one-fourth of all patients consuming opioids engaged in one or more risk behaviors; higher number of opioid prescriptions and addition of even a small number of benzodiazepine prescriptions dramatically increased these odds. PDMPs can be helpful in identifying opioid users at high-risk for misuse. This information could be used to target efforts to reduce the prescription drug epidemic. (Am J Addict 2017;26:822–829).",
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