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Changes in Associations of Prescription Opioid Use Disorder and Illegal Behaviors Among Adults in the United States from 2002-2014.

Addiction 2019 April 30
BACKGROUND AND AIMS: In the United States, availability of prescription opioids has decreased in recent years. Whether there have been corresponding changes in the likelihood of persons with prescription opioid use disorder (POUD) to engage in illegal behaviors related to drug use remains unknown. We examined changes in prevalence of illegal behaviors between persons with and without POUD over time, and how transactions for obtaining opioids have changed among persons with POUD over time.

DESIGN: Temporal trend analysis of repeated cross-sectional data.

SETTING: United States household dwelling population from all 50 states and District of Columbia.

PARTICIPANTS: Adult subsamples from the 2002-2014 National Survey of Drug Use and Health (n=5,393 persons with POUD; n=486,768 persons without POUD).

MEASUREMENTS: Outcome variables were selected illegal behaviors and sources of opioids used non-medically. POUD was defined using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Time was treated as a continuous variable. The variable of interest for each illegal behavior analysis was the interaction between POUD diagnosis and time. Covariates included age, sex, and race/ethnicity. Findings Over the 13-year period examined, the adjusted interaction odds ratio (AIOR) describing the change in association between POUD and selling illicit drugs increased by a factor of 2.41 (95% CI: 1.56-3.71, p<.001). Similar trends were noted for stealing (AIOR 2.12, 95% CI: 1.31-3.44, p=.002) and for lifetime history of arrest (AIOR 1.53, 95% CI: 1.06-2.19, p=.021). Persons with POUD became less likely to receive opioids for free from friends and family (AOR 0.42, 95% CI: 0.25-0.71, p=.001) and more likely to buy them from friends and family (AOR 3.29, 95% CI: 1.76-6.13, p<.001) from 2005-2014.

CONCLUSIONS: In the United States, against a backdrop of a decreasing prescription opioid supply, rates of some crimes potentially related to drug use increased among persons with prescription opioid use disorder (POUD) compared with those without POUD from 2002-2014.

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