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. 2012 Jan;42(1):87-94.
doi: 10.1016/j.jsat.2011.07.003. Epub 2011 Aug 9.

Patterns of prescription opioid abuse and comorbidity in an aging treatment population

Theodore J Cicero  1 , Hilary L Surratt, Steven Kurtz, M S Ellis, James A Inciardi
Affiliations

Patterns of prescription opioid abuse and comorbidity in an aging treatment population

Theodore J Cicero et al. J Subst Abuse Treat. 2012 Jan.

Abstract

Very little is known about the impact of age and gender on drug abuse treatment needs. To examine this, we recruited 2,573 opioid-dependent patients, aged from 18 to 75 years, entering treatment across the country from 2008 to 2010 to complete a self-administered survey examining drug use histories and the extent of comorbid psychiatric and physical disorders. Moderate to very severe pain and psychiatric disorders, including polysubstance abuse, were present in a significant fraction of 18- to 24-year-olds, but their severity grew exponentially as a function of age: 75% of those older than 45 years had debilitating pain and psychiatric problems. Women had more pain than men and much worse psychiatric issues in all age groups. Our results indicate that a "one-size-fits-all" approach to prevention, intervention, and treatment of opioid abuse that ignores the shifting needs of opioid-abusing men and women as they age is destined to fail.

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Conflict of interest statement

Conflict of Interest: With the exception of Matthew Ellis, all of the authors serve as consultants to the non-profit post-marketing surveillance system Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System which collects subscription fees from 11 pharmaceutical firms. None of the subscribers would appear to have any interest in the outcome of this study.

Figures

Figure 1
Figure 1. Frequency distribution of age of treatment clients
Percent of the total population (N=2,573) falling into the age brackets shown. The numbers in each age group are shown in italics on the y axis.
Figure 2
Figure 2. SF36V2 composite physical and mental health scores for both the treatment samples and population norms
Mean [95% confidence limits] composite physical and mental health scores for males and females on the SF-36V2 health survey. Age adjusted population norms, derived from large population studies carried out in validating the SF-36V2 instrument, for each age group are also shown.
Figure 3
Figure 3. The percent of male and female patients of various ages with co-morbid bodily pain, psychiatric disorders, alcoholism and nicotine dependence
Mean percent of those in each age group who reported moderate to very severe pain (panel A), psychiatric disorders (panel B), and met criteria for alcoholism (panel C) or nicotine dependence (panel D).
Figure 4
Figure 4. The percent of the treatment sample who used the modes of diversion shown as a function of age
The percent of those in each age bracket who used the modes of diversion shown. Odds ratios for the influence of gender and age on the disorders shown are contained in tables 1 and 2 respectively.
See this image and copyright information in PMC

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