Prevalence and Patterns of Nonmedical Use of OxyContin ® and Other Pain Relievers Joe Gfroerer...
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Transcript of Prevalence and Patterns of Nonmedical Use of OxyContin ® and Other Pain Relievers Joe Gfroerer...
Prevalence and Patterns of Nonmedical Use of
OxyContin® and Other Pain Relievers
Joe Gfroerer
Office of Applied Studies
Substance Abuse and Mental Health Services Administration
Anesthetic and Life Support Drugs and Drug Safety and Risk Management
Advisory Committees
May 5, 2008
2
National Survey on Drug Use and Health (NSDUH)
• Representative nationally and in each State
• Civilian, noninstitutional population, age 12+
• Face-to-face interview, 1 hour
• Computer-assisted, mainly self-administered
• 67,500 respondents each year
• Survey changed in 1999 and in 2002, creating breaks in trend
• Response rates (2006): – 91% of Households selected
– 74% of Persons selected within households (85% for youth, 73% for adults)
3
NSDUH Data on Illicit Drug Use
Illicit drug use: Use of an illicit drug , or nonmedical use of prescription drugs; For each drug:
• Recency of use
– Lifetime, Past year, Past month
• Frequency of use
• Date of first use
– Incidence/First time use within past year
• Dependence and abuse
– Based on DSM-IV criteria
• Received treatment in past year for problem with drug
4
Nonmedical Prescription Drug Use: NSDUH Definition
“Not prescribed for you”
OR
“You took the drug only for the experience
or feeling it caused”
(Excludes OTC)
5
Prescription Drug Questioning Strategy
• Primary focus is on therapeutic classes (TCs):– Pain Relievers, Tranquilizers, Stimulants, Sedatives
• Specific pharmaceuticals asked for each TC:– Lifetime use only (except OxyContin® and
methamphetamine)
– Includes mix of brand-name and generic drugs
– Done mainly to help respondents understand the TC
– “Pill cards” show specific pharmaceuticals
– “Any other drug” in the TC collected as write-in(s)
6
Drug groups above the red line are asked separately
Drug groups below the red line are asked in tandem with followup to identify which one(s)
Any other drugs in TC are specified by write-in.
“PILL CARDS”
7
Lifetime Nonmedical Use of Selected Pain Relievers, Age 12 or Older: 2006
1.1
1.6
2.5
2.5
4.1
6.8
7.4
11.5
19.5
19.6
0.0 5.0 10.0 15.0 20.0 25.0
Ultram®
Methadone
Morphine
Demerol®
OxyContin®
Codeine
Hydrocodone
Percocet®, Percodan®, or Tylox®
Darvocet®, Darvon®, or Tylenol® with Codeine
Vicodin®, Lortab®, or Lorcet®
Numbers (in Millions)
Nonmedical Pain Reliever Use:
Trends and Patterns
9
Nonmedical Pain Reliever Use, Age 12 or Older: 2002 and 2006
33.5
12.6
5.2
29.6
11.0
4.4
0
5
10
15
20
25
30
35
40 2002 2006
(12.6%)
(1.9%)
(4.7%)
Numbers (in Millions)
Lifetime Use
Past Month Use
Past Year Use
(13.6%)
(5.1%)
(2.1%)
Note: Differences between 2002 and 2006 are statistically significant for lifetime, past year, and past month use.
10
1509
360
1635
547
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800Number in Thousands
20022006
Received Treatment for Pain Reliever Problem During Last Treatment Visit,
within Past Year
Past Year Nonmedical Pain Reliever Dependence or Abuse
Past Year Pain Reliever Dependence or Abuse and Treatment, Age 12+: 2002 and 2006
+
+ Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.
11
Past Year Nonmedical Use of Pain Relievers, by Age: 2002 and 2006
Percent Used in Past Year
7.6
11.4
6.1
2.4
7.2
12.4
7.4
2.7
0
5
10
15
20
12 to 17 18 to 25 26 to 34 35 and older
2002 2006
+ Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.
+
+
12
Lifetime Nonmedical Use of Selected Pain Relievers, Ages 18-25: 2002 and 2006
Percent Ever Used
12.2
7.4
13.3
6.15
2.6
12.3
8.8
18.0
6.17.8
5.1
0
5
10
15
20
Codeine Hydrocodone OxyContin®
2002 2006
+ Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.
+
+
+
+
Darvocet, Darvon, or Tylenol w/Codeine
Percocet, Percodan, or Tylox
Vicodin, Lortab, or Lorcet
13
Lifetime Nonmedical Use of Selected Pain Relievers, Ages 26-34: 2002 and 2006
Percent Ever Used
10.5
5.5
8.9
3.6 2.81
11.7
7.8
14.7
4.25.6
2.7
0
5
10
15
20
Codeine Hydrocodone OxyContin®
2002 2006
+ Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.
+
+
+
+
Darvocet, Darvon, or Tylenol w/Codeine
Percocet, Percodan, or Tylox
Vicodin, Lortab, or Lorcet
14
Nonmedical Use of Pain Relievers in Past Year among Persons Aged 12 or Older, by Substate Region: Percentages,
Annual Averages Based on 2002-2004
15
Source Where Pain Relievers Were Obtained for Most Recent Nonmedical Use among Past
Year Users Aged 12 or Older: 2006
Note: Totals may not sum to 100% because of rounding or because suppressed estimates are not shown.1 The Other category includes the sources: “Wrote Fake Prescription,” “Stole from Doctor’s
Office/Clinic/Hospital/Pharmacy,” and “Some Other Way.”
Bought/Took from Friend/Relative
14.8%
Drug Dealer/Stranger
3.9%
Bought on Internet
0.1% Other 1
4.9%
Free from Friend/Relative
7.3%
Bought/Took fromFriend/Relative
4.9%
OneDoctor80.7%
Drug Dealer/Stranger
1.6%Other 1
2.2%
Source Where Respondent Obtained
Source Where Friend/Relative Obtained
One Doctor19.1%
More than One Doctor
1.6%
Free from Friend/Relative
55.7%
More than One Doctor3.3%
16
Sources of Rx Pain Relievers among Persons Who Used Pain Relievers Nonmedically in the
Past Year: Combined 2005 and 2006
Percent among Past Year Users
4.5
0.4
1.6
4.8
4.1
18.0
8.8
57.7
5.1
1.7
4.0
4.6
8.7
27.1
14.3
34.6
0 10 20 30 40 50 60 70
Frequent Users(100+ days)All Users
Free from Friend/Relative
Prescriptions from 1 Doctor
Bought from Friend/relative
Drug Dealer/Stranger
Took from Friend/relative
Prescription from 2+ Doctors
Internet
Other
Pain Reliever and OxyContin® Initiates
18
Past Year Initiates for Specific Illicit Drugs among Persons Aged 12 or Older:
2006Numbers in Thousands
2,1502,063
1,112977
860 845 783
533
267 26491
0
500
1,000
1,500
2,000
2,500
Marijuana LSD
Pain Relievers
Cocaine
SedativesTranquilizers HeroinInhalantsEcstasy
Stimulants OxyContin®
19
Mean Age at First Use for Specific Illicit Drugs among Past Year Initiates
Aged 12 to 49: 2006Age in Years
15.717.4
19.4 20.3 20.6 20.721.9 22.6 23.0 24.0
26.5
0
5
10
15
20
25
30
Marijuana
StimulantsPain Relievers
Heroin
LSD
TranquilizersCocaine
EcstasyInhalants
OxyContin®
Sedatives
20
Lifetime Use of Other Drugs among Past Year Nonmedical Pain Reliever Initiates, Age 12 or Older : Annual Averages, 2004-2006
32
68
19
28
10
10
20
30
40
50
60
70
80
90
100
Percent of New Pain Reliever Users
Tranqs, Seds, or Stims
Nonmedically
HallucinogensCocaineMarijuana Heroin
21
Lifetime Use of Other Drugs among Past Year Nonmedical OxyContin® Initiates,
Age 12 or Older : Annual Averages, 2004-2006
70
95
66 65
12
0
10
20
30
40
50
60
70
80
90
100
Percent of New OxyContin® Users
Tranqs, Seds, or Stims
Nonmedically
HallucinogensCocaineMarijuana Heroin
22
Lifetime Nonmedical Use of Other Pain Relievers among Past Year Nonmedical OxyContin® Initiates, Age 12 or
Older: Annual Averages, 2004-2006
17.4
18.0
21.0
48.4
51.2
55.5
58.2
79.2
0.0 20.0 40.0 60.0 80.0 100.0
Demeral
Methadone
Morphine
Codeine
Hydrocodone
Percent
Darvocet®, Darvon®, or Tylenol® with Codeine
Vicodin®, Lortab®, or Lorcet®
Percocet®, Percodan®, or Tylox®
®
Nonmedical OxyContin® Use:
Trends and Patterns
24
Trends in Past Year Indicators of Nonmedical Use of OxyContin®, Ages 12
and Older: 2004 to 2006Number in Thousands
+ Difference between this estimate and the 2006 estimate is statistically significant at the .05 level.
615
1213
351
526
1226
387
533
1323
330
0
200
400
600
800
1000
1200
1400
Past Year Initiates Past Year Users Past Year Users withDep/Ab
2004
2005
2006
25
0.76
0.23
1.74
0.520.62
0.14
0.32
0.120.080.01
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2.0
Percent
Past Year OxyContin® Use
Aged 12-17Aged 18-25Aged 26-34Aged 35-49Aged 50 or Older
Past Year Pain Reliever Dependence or Abuse, with OxyContin® Use
OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Age Group: Annual Averages, 2004-2006
26
0.64
0.16
0.40
0.13
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
Percent
MaleFemale
Past Year Pain Reliever Dependence or Abuse, with Nonmedical OxyContin® Use
Past Year Nonmedical OxyContin® Use
OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Gender, Age
12+: Annual Averages 2004-2006
27
0.67
0.20
0.090.02
0.09
0.01
0.23
0.04
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
White
Black
Asian
Hispanic
Percent
Past Year Pain Reliever Dependence or Abuse, with Nonmedical OxyContin® Use
Past Year Nonmedical OxyContin® Use
OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Race/Ethnicity,
Age 12+: Annual Averages, 2004-2006
28
OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by County
Type, Age 12+: Annual Averages, 2004-2006
0.43
0.11
0.63
0.18
0.59
0.23
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
Percent
Large MetroSmall MetroNonmetro
Past Year Pain Reliever Dependence or Abuse with Nonmedical OxyContin® Use
Past Year OxyContin® Use
29
OxyContin® Use in Lifetime among Persons Aged 12 or Older, by State: Percentages,
Annual Averages Based on 2002-2006 NSDUHs
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002-2006.
30
Past Year Use of Selected Illicit Drugs among Past Year Nonmedical Pain Reliever Users and Nonusers Aged 12 and
Older: Annual Averages, 2004-2006
75.7
47.7
35.9
12.1
46.1
17.513.2
1.2
8.51.4 0.9 0.1
0
10
20
30
40
50
60
70
80
90 Used OxyContinUsed Pain Relievers, not OxyContinNo Pain Reliever Misuse
Percent Using in Past Year
Marijuana Cocaine Hallucinogens Heroin
31
Dependence and Abuse Among Past Year Users of Selected Substances, Ages 12+: Annual
Averages, 2004-2006
510
20
10 84
9
237
7
8
6
5
4
5
4
0
10
20
30
40
Abuse
Dependence
Percentage of Past Year Users
12
1714
28
14
913
28
Note: Percentages refer to dependence/abuse for each drug among past year users of that drug, except for OxyContin, which reflects pain reliever dependence/abuse among past year OxyContin users.