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Internet-based Survey of Nonmedical Prescription Opioid Use in the United States

Katz, Nathaniel MD, MS* †; Fernandez, Kathrine MPH*; Chang, Alan BA*; Benoit, Christine BA*; Butler, Stephen F. PhD*

doi: 10.1097/AJP.0b013e318167a087
Original Articles

Introduction Prescription opioid misuse is a growing problem in the United States. There are limited data to illuminate the nature of this issue. The Internet seems to be a novel approach in surveying populations of opioid users. An Internet-based survey of nonmedical opioid users visiting informational drug websites was used to measure rates of nonmedical use and characterize users.

Methods The prescription opioid module of the Addiction Severity Index Multimedia Version Connect was adapted to include variables such as favorite opioid. Links to the survey were posted on an informational drug website. Nonmedical use rates for KADIAN (morphine sulfate extended-release tablets), OxyContin (oxycodone HCl controlled-release tablets), Vicodin (hydrocodone bitartrate and acetaminophen tablets), and product-classes (morphine ER, oxycodone ER, and hydrocodone) were calculated. Descriptive statistics were calculated for remaining questions.

Results During a 1-month recruitment period, 896 valid individuals completed the survey. Majority were white (78.3%) and male (72.4%). Participants were less likely to have used KADIAN in the past 30 days compared with OxyContin (P<0.0001) and Vicodin (P=0.0021). Additionally, participants were less likely to have used morphine ER in the previous 30 days than either oxycodone ER (P<0.0001) or hydrocodone (P<0.0001). Among OxyContin, Vicodin, and KADIAN users, OxyContin (43.8%), Dilaudid (15.6%), and fentanyl (9.4%) were the top 3 favorite opioids.

Discussion This project demonstrates the feasibility of conducting product-specific, online surveys with rapid recruitment of participants from websites. This approach differentiates rates of nonmedical use of specific prescription opioids and provides other insights into individuals who nonmedically use opioids.

*Inflexxion Inc, Newton

Tufts University School of Medicine, Boston, MA

Supported by Alpharma Pharmaceuticals LLC.

Reprints: Stephen F. Butler, PhD, Inflexxion Inc, 320 Needham Street, Suite 100, Newton, MA 02464 (e-mail:

Received for publication May 25, 2007; revised December 13, 2007; accepted January 8, 2008

© 2008 Lippincott Williams & Wilkins, Inc.