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Prevalence and Patterns of Nonmedical Use of OxyContin ® and Other Pain Relievers

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 .

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Prevalence and Patterns of Nonmedical Use of OxyContin ® and Other Pain Relievers

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  1. 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. “PILL CARDS” 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.

  7. Lifetime Nonmedical Use of Selected Pain Relievers, Age 12 or Older: 2006 Numbers (in Millions)

  8. Nonmedical Pain RelieverUse: Trends and Patterns

  9. Nonmedical Pain Reliever Use, Age 12 or Older: 2002 and 2006 Numbers (in Millions) (13.6%) (5.1%) (2.1%) Past Year Use Past Month Use Lifetime Use Note: Differences between 2002 and 2006 are statistically significant for lifetime, past year, and past month use.

  10. 2002 2006 Past Year Pain Reliever Dependence or Abuse and Treatment, Age 12+: 2002 and 2006 Number in Thousands + Received Treatment for Pain Reliever Problem During Last Treatment Visit, within Past Year Past Year Nonmedical Pain Reliever Dependence or Abuse + 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 + + + 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 + + + + Percocet, Percodan, or Tylox Darvocet, Darvon, or Tylenol w/Codeine Vicodin, Lortab, or Lorcet + Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.

  13. Lifetime Nonmedical Use of Selected Pain Relievers, Ages 26-34: 2002 and 2006 Percent Ever Used + + + + Percocet, Percodan, or Tylox Darvocet, Darvon, or Tylenol w/Codeine Vicodin, Lortab, or Lorcet + Difference between this estimate and the 2002 estimate is statistically significant at the .05 level.

  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 Source Where Respondent Obtained Bought on Internet0.1% Drug Dealer/Stranger3.9% Other 14.9% Source Where Friend/Relative Obtained More than One Doctor 1.6% More than One Doctor3.3% Free from Friend/Relative7.3% Free from Friend/Relative55.7% One Doctor 19.1% Bought/Took fromFriend/Relative4.9% OneDoctor 80.7% Bought/Took from Friend/Relative14.8% Drug Dealer/Stranger1.6% Other 12.2% 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.”

  16. Free from Friend/Relative Bought from Friend/relative Prescriptions from 1 Doctor Drug Dealer/Stranger Took from Friend/relative Prescription from 2+ Doctors Internet Other Percent among Past Year Users Sources of Rx Pain Relievers among Persons Who Used Pain Relievers Nonmedically in the Past Year: Combined 2005 and 2006

  17. Pain Reliever and OxyContin® Initiates

  18. Marijuana Cocaine Stimulants OxyContin® LSD Pain Relievers Tranquilizers Ecstasy Inhalants Sedatives Heroin Past Year Initiates for Specific Illicit Drugs among Persons Aged 12 or Older: 2006 Numbers in Thousands

  19. OxyContin® Marijuana Cocaine Heroin Tranquilizers Inhalants LSD Ecstasy Pain Relievers Stimulants Sedatives Mean Age at First Use for Specific Illicit Drugs among Past Year Initiates Aged 12 to 49: 2006 Age in Years

  20. Lifetime Use of Other Drugs among Past Year Nonmedical Pain Reliever Initiates, Age 12 or Older : Annual Averages, 2004-2006 Percent of New Pain RelieverUsers Tranqs, Seds, or Stims Nonmedically Marijuana Cocaine Hallucinogens Heroin

  21. Lifetime Use of Other Drugs among Past Year Nonmedical OxyContin® Initiates, Age 12 or Older : Annual Averages, 2004-2006 Percent of New OxyContin® Users Tranqs, Seds, or Stims Nonmedically Marijuana Cocaine Hallucinogens Heroin

  22. Lifetime Nonmedical Use of Other Pain Relievers among Past Year Nonmedical OxyContin® Initiates, Age 12 or Older: Annual Averages, 2004-2006 Vicodin®, Lortab®, or Lorcet® Percocet®, Percodan®, or Tylox® Darvocet®, Darvon®, or Tylenol® with Codeine ® Percent

  23. Nonmedical OxyContin®Use: Trends and Patterns

  24. Trends in Past Year Indicators of Nonmedical Use of OxyContin®, Ages 12 and Older: 2004 to 2006 Number in Thousands + Difference between this estimate and the 2006 estimate is statistically significant at the .05 level.

  25. Aged 12-17 Aged 18-25 Aged 26-34 Aged 35-49 Aged 50 or Older OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Age Group: Annual Averages, 2004-2006 Percent Past Year OxyContin®Use Past Year Pain Reliever Dependence or Abuse, with OxyContin® Use

  26. Male Female OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Gender, Age 12+: Annual Averages 2004-2006 Percent Past Year Nonmedical OxyContin® Use Past Year Pain Reliever Dependence or Abuse, with Nonmedical OxyContin® Use

  27. OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by Race/Ethnicity, Age 12+: Annual Averages, 2004-2006 Percent Past Year Pain Reliever Dependence or Abuse, with Nonmedical OxyContin® Use Past Year Nonmedical OxyContin® Use

  28. Large Metro Small Metro Nonmetro OxyContin® Use and Pain Reliever Dependence or Abuse with OxyContin® Use, by County Type, Age 12+: Annual Averages, 2004-2006 Percent Past Year OxyContin® Use Past Year Pain Reliever Dependence or Abuse with Nonmedical 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 Percent Using in Past Year Marijuana Heroin Hallucinogens Cocaine

  31. Dependence and Abuse Among Past Year Users of Selected Substances, Ages 12+: Annual Averages, 2004-2006 Percentage of Past Year Users 28 28 17 14 14 13 12 9 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.

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