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Prescription Opioid Use Among Patients Seeking Treatment for Opioid Dependence

Canfield, Marta C. MD; Keller, Craig E. BS; Frydrych, Lynne M. MS; Ashrafioun, Lisham MA; Purdy, Christopher H. MA; Blondell, Richard D. MD

Journal of Addiction Medicine: June 2010 - Volume 4 - Issue 2 - p 108-113
doi: 10.1097/ADM.0b013e3181b5a713
Original Article

Objective: This study was designed to assess nonmedical prescription opioid use among a sample of opioid dependent participants.

Methods: A cross-sectional survey was conducted with a convenience sample of patients hospitalized for medical management of opioid withdrawal. We collected data related to participant demographics, socioeconomic characteristics, the age of first opioid use, types of opioids preferred, and routes of administration. We also asked participants to describe how they first began using opioids and how their use progressed over time.

Results: Among the 75 participants, the mean age was 32 years (SD: ±11, range: 18–70 years), 49 (65%) were men, 58 (77%) considered themselves to be “white,” 55 (74%) had a high school diploma or equivalent, and 39 (52%) were unemployed. All of these participants considered themselves to be “addicted.” Thirty-one (41%) felt that their addiction began with “legitimate prescriptions,” 24 (32%) with diverted prescription medications, and 20 (27%) with “street drugs” from illicit sources; however, 69 (92%) had reported purchasing opioids “off the street” at some point in time. Thirty-seven (49%) considered heroin to be their current preferred drug, and 43 (57%) had used drugs intravenously.

Conclusions: We found that many treatment-seeking opioid-dependent patients first began using licit prescription drugs before obtaining opioids from illicit sources. Later, they purchased heroin, which they would come to prefer, because it was less expensive and more effective than prescription drugs.

From the Department of Family Medicine, State University of New York, University at Buffalo, Family Medicine Research Institute, SUNY Clinical Center, Buffalo, NY.

Received for publication December 18, 2008; accepted June 23, 2009.

Send correspondence and reprint requests to Richard D. Blondell, MD, Department of Family Medicine, 462 Grider Street, CC-190, Buffalo, NY 14215. e-mail:

Supported, in part, by a grant from the University at Buffalo Foundation Family Medicine Endowment (to C.E.K), a grant K23 AA 015616 from the National Institute on Alcohol Abuse and Alcoholism (to R.D.B. and L.M.F.), and a grant (1060512-1-35905) from the University at Buffalo Interdisciplinary Research Fund.

© 2010 American Society of Addiction Medicine