TY - JOUR
T1 - Factors predicting development of opioid use disorders among individuals who receive an initial opioid prescription
T2 - Mathematical modeling using a database of commercially-insured individuals
AU - Cochran, Bryan N.
AU - Flentje, Annesa
AU - Heck, Nicholas C.
AU - Van Den Bos, Jill
AU - Perlman, Dan
AU - Torres, Jorge
AU - Valuck, Robert
AU - Carter, Jean
N1 - Funding Information:
This research was supported by a grant from the National Institute on Drug Abuse ( R03 DA023237-01A1 ) awarded to Bryan N. Cochran and Jean Carter. Additional support for Annesa Flentje was provided by National Institute on Drug Abuse ( T32 DA007250 and P50 DA009253 ). The funding sources had no involvement in the study design, analysis, report writing, or other aspects of the project.
PY - 2014/5/1
Y1 - 2014/5/1
N2 - Background: Prescription drug abuse in the United States and elsewhere in the world is increasing at an alarming rate with non-medical opioid use, in particular, increasing to epidemic proportions over the past two decades. It is imperative to identify individuals most likely to develop opioid abuse or dependence to inform large-scale, targeted prevention efforts. Methods: The present investigation utilized a large commercial insurance claims database to identify demographic, mental health, physical health, and healthcare service utilization variables that differentiate persons who receive an opioid abuse or dependence diagnosis within two years of filling an opioid prescription (OUDs) from those who do not receive such a diagnosis within the same time frame (non-OUDs). Results: When compared to non-OUDs, OUDs were more likely to: (1) be male (59.9% vs. 44.2% for non-OUDs) and younger (M= 37.9 vs. 47.7); (2) have a prescription history of more opioids (1.7 vs. 1.2), and more days supply of opioids (M= 272.5, vs. M= 33.2; (3) have prescriptions filled at more pharmacies (M= 3.3 per year vs. M= 1.3); (4) have greater rates of psychiatric disorders; (5) utilize more medical and psychiatric services; and (6) be prescribed more concomitant medications. A predictive model incorporating these findings was 79.5% concordant with actual OUDs in the data set. Conclusions: Understanding correlates of OUD development can help to predict risk and inform prevention efforts.
AB - Background: Prescription drug abuse in the United States and elsewhere in the world is increasing at an alarming rate with non-medical opioid use, in particular, increasing to epidemic proportions over the past two decades. It is imperative to identify individuals most likely to develop opioid abuse or dependence to inform large-scale, targeted prevention efforts. Methods: The present investigation utilized a large commercial insurance claims database to identify demographic, mental health, physical health, and healthcare service utilization variables that differentiate persons who receive an opioid abuse or dependence diagnosis within two years of filling an opioid prescription (OUDs) from those who do not receive such a diagnosis within the same time frame (non-OUDs). Results: When compared to non-OUDs, OUDs were more likely to: (1) be male (59.9% vs. 44.2% for non-OUDs) and younger (M= 37.9 vs. 47.7); (2) have a prescription history of more opioids (1.7 vs. 1.2), and more days supply of opioids (M= 272.5, vs. M= 33.2; (3) have prescriptions filled at more pharmacies (M= 3.3 per year vs. M= 1.3); (4) have greater rates of psychiatric disorders; (5) utilize more medical and psychiatric services; and (6) be prescribed more concomitant medications. A predictive model incorporating these findings was 79.5% concordant with actual OUDs in the data set. Conclusions: Understanding correlates of OUD development can help to predict risk and inform prevention efforts.
KW - Health claims database
KW - Opioid dependence
KW - Opioid use disorder
KW - Prescription drug misuse
UR - http://www.scopus.com/inward/record.url?scp=84897559346&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2014.02.701
DO - 10.1016/j.drugalcdep.2014.02.701
M3 - Article
C2 - 24679839
AN - SCOPUS:84897559346
SN - 0376-8716
VL - 138
SP - 202
EP - 208
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 1
ER -