Prevalence and Patterns of Nonmedical Use of OxyContin

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
• November 13, 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 (2007)
• 90 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 2007
Percent Using in Lifetime
8
Nonmedical Pain Reliever Use Trends and
Patterns
9
Nonmedical Pain Reliever Use, Age 12 or Older
2002 and 2007
Numbers (in Millions)
(13.3)
(12.6)
(5.0)
(4.7)
(2.1)
(1.9)
Lifetime Use
Past YearUse
Past MonthUse
Difference between this estimate and the 2002
estimate is statistically significant at the .05
level.
10
Past Year Pain Reliever Dependence or Abuse and
Treatment, Aged 12 or Older 2002 and 2007
Numbers (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 2007
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 2007
Percent Ever Used
Darvocet, Darvon, or Tylenol w/Codeine
Percocet, Percodan, or Tylox
Vicodin, Lortab, or Lorcet
Hydrocodone
Codeine
OxyContin
Morphine
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 2007
Percent Ever Used
Darvocet, Darvon, or Tylenol w/Codeine
Percocet, Percodan, or Tylox
Vicodin, Lortab, or Lorcet
Hydrocodone
Codeine
OxyContin
Morphine
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
2004-2006
15
Source Where Pain Relievers Were Obtained for
Most Recent Nonmedical Use among Past Year Users
Aged 12 or Older 2007
Source Where Respondent Obtained
Source Where Friend/Relative Obtained
Bought on Internet0.5
Drug Dealer/Stranger4.1
More than One Doctor2.9
Other 14.2
More than One Doctor 2.6
Free from Friend/Relative6.6
Free from Friend/Relative56.5
One Doctor 18.1
Bought/Took fromFriend/Relative5.9
OneDoctor 81.0
Drug Dealer/Stranger1.8
Bought/Took from Friend/Relative14.1
Bought on Internet0.1
Other 11.8
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 Doctors
Office/Clinic/Hospital/Pharmacy," and "Some Other
Way."
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
17
Initiation First-time Use within the Past 12
Months
18
Specific Drug Used When Initiating Illicit Drug
Use among Past Year Initiates of Illicit Drugs
Aged 12 or Older 2007
Inhalants10.7
Pain Relievers19.0
Tranquilizers6.5
Stimulants4.1
Marijuana56.2
Hallucinogens 2.0
Sedatives1.1
Cocaine 0.6
2.7 Million Initiates of Illicit Drugs
Note The percentages add to greater than 100
percent because of a small number of respondents
initiating multiple drugs on the same day.
19
Past Year Initiates for Specific Illicit Drugs
among Persons Aged 12 or Older 2007
Numbers (in Thousands)
20
Mean Age at First Use for Specific Illicit Drugs
among Past Year Initiates Aged 12 to 49 2007
Age in Years
Marijuana
Sedatives
Cocaine
PainRelievers
Stimulants
Inhalants
OxyContin
LSD
Tranquilizers
Heroin
Ecstasy
21
Past Year Pain Reliever Initiation, Overall and
with OxyContin or Morphine Use, among Persons
Aged 12 or Older 2002-2007
Percent of Population
Pain Reliever Initiates
Pain Reliever Initiates with OxyContin Use
Pain Reliever Initiates with Morphine Use
Difference between this estimate and the 2007
estimate is statistically significant at the .05
level.
22
Lifetime Use of Other Drugs among Past Year
Nonmedical Pain Reliever Initiates, Age 12 or
Older Annual Averages, 2004-2006
Percent of New Pain Reliever Users
Tranqs, Seds, or Stims Nonmedically
Hallucinogens
Cocaine
Marijuana
Heroin
23
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
Hallucinogens
Cocaine
Marijuana
Heroin
24
Lifetime Use of Other Drugs among Past Year
Nonmedical Pain Reliever Initiates Who Used
Morphine, Age 12 or Older Annual Averages,
2004-2007
Percent of New Pain Reliever Users with Morphine
Use
Tranqs, Seds, or Stims Nonmedically
Hallucinogens
Cocaine
Marijuana
Heroin
25
Lifetime Nonmedical Use of Other Pain Relievers
among Past Year Nonmedical OxyContin Initiates,
Age 12 or Older Annual Averages, 2004-2006
Percent
26
Nonmedical OxyContin Use Trends and Patterns
27
Trends in Past Year Indicators of Nonmedical Use
of OxyContin, Ages 12 and Older 2004 to 2007
Numbers (in Thousands)
Difference between this estimate and the 2007
estimate is statistically significant at the .05
level.
28
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
29
OxyContin Use and Pain Reliever Dependence or
Abuse with OxyContin Use, by Gender, Age 12
Annual Averages 2004-2006
Percent
Past Year Pain Reliever Dependence or Abuse, with
Nonmedical OxyContin Use
Past Year Nonmedical OxyContin Use
30
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
31
OxyContin Use and Pain Reliever Dependence or
Abuse with OxyContin Use, by County Type, Age
12 Annual Averages, 2004-2006
Percent
Past Year Pain Reliever Dependence or Abuse with
Nonmedical OxyContin Use
Past Year OxyContin Use
32
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.
33
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
Cocaine
Hallucinogens
Heroin
34
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.