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. 2019 Jan 1:194:468-475.
doi: 10.1016/j.drugalcdep.2018.11.011. Epub 2018 Nov 26.

Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco

William S John  1 , He Zhu  2 , Paolo Mannelli  2 , Geetha A Subramaniam  3 , Robert P Schwartz  4 , Jennifer McNeely  5 , Li-Tzy Wu  6
Affiliations

Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco

William S John et al. Drug Alcohol Depend. .

Abstract

Background: Current data suggest that opioid misuse or opioid use disorder (OUD) may be over represented among tobacco users. However, this association remains understudied in primary care settings. A better understanding of the extent of heterogeneity in opioid misuse among primary care patients who use tobacco may have implications for improved primary care-based screening, prevention, and intervention approaches.

Methods: Data were derived from a sample of 2000 adult (aged ≥18) primary care patients across 5 distinct clinics. Among past-year tobacco users (n = 882), we assessed the prevalence of opioid misuse and OUD by sociodemographic characteristics and past-year polysubstance use. Latent class analysis (LCA) was used to identify heterogeneous subgroups of tobacco users according to past-year polysubstance use patterns. Multinomial logistic regression was used to examine variables associated with LCA-defined class membership.

Results: Past-year tobacco use was reported by >84% of participants who reported past-year opioid misuse or OUD. Among those reporting past-year tobacco use, the prevalence of past-year opioid misuse and OUD was 14.0% and 9.5%, respectively. The prevalence of opioid misuse or OUD was highest among tobacco users who were male or unemployed. Three LCA-defined classes among tobacco users were identified including a tobacco-minimal drug use group (78.0%), a tobacco-cannabis use group (10.1%), and a tobacco-opioid/polydrug use group (11.9%). Class membership differed by sociodemographic characteristics.

Conclusions: Results from this study support the benefit of more comprehensive assessment of and/or monitoring for opioid misuse among primary care patients who use tobacco, particularly for those who are male, unemployed, or polydrug users.

Keywords: Latent class analysis; Opioid use disorder; Polysubstance; Primary care; Tobacco use.

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Conflict of interest statement

Conflicts of interest: The other authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Estimated probabilities of drug use for the 3-class latent class analysis model (n=878).
See this image and copyright information in PMC

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