UTSA researchers examine patterns of prescription opioid misuse and other substance use

On average, 130 Americans die every day from an opioid overdose and almost 218,000 Americans died from overdoses related to prescription opioids from 1999 to 2017, according to the Centers for Disease Control and Prevention (CDC).

Researchers at The University of Texas at San Antonio (UTSA) have studied the opioid epidemic in a representative sample from the United States and found that the majority of people misusing prescription opioids are also using other licit and illicit substances.

Timothy Grigsby and Jeffrey T. Howard, who are both assistant professors in the Department of Kinesiology, Health and Nutrition in the UTSA College of Education and Human Development (COEHD), recently published their findings in The American Journal on Addictions.

According to their study, males and younger respondents (adolescents aged 12-17 and young adults aged 18-25) were more likely to report past 30 day prescription opioid and illicit or polydrug use (using more than one other drug in the past month).

Grigsby, the lead author on the study, said most individuals who reported prescription opioid misuse in the survey also reported the use of cigarettes, alcohol, marijuana or hard drugs.

In addition, the researchers discovered that prescription opioid misusers who used more than one other drug in the past month had the greatest odds of reporting behavioral problems (stealing property worth $50 or more, selling illegal drugs, contracting an STD), mental health problems (suicidal ideation and major depressive episode) and the need for substance use treatment.

“If we want to end the opioid epidemic, and stop a similar one from taking its place, then we need to consider the entire clinical picture of the patient including their use of other substances,” said Grigsby.

National Survey on Drug Use and Health (NSDUH) data indicates that the primary reason for misuse of prescription pain killers is pain (62.6 percent). Individuals with existing physical, behavioral and mental health problems may be at a higher risk of prescription opioid misuse due to associated pain related symptoms or as a coping mechanism for psychological and behavioral problems.

“So much of the public discussion focuses on the opioid epidemic as though it is happening in a vacuum when, in fact, so many people misusing prescription opioids are also engaging in other substance use,” explained Grigsby. “I wanted to get a better sense of what patterns of prescription opioid misuse and co-morbid substance use existed and how these patterns were associated with different health outcomes.”

The assistant professor’s primary research interest is on the study of substance misuse and developing screening and intervention methods to stop the escalation of substance use and the pattern of associated negative consequences (blacking out, missing school or work, stealing to buy more drugs).

Previously, Grigsby analyzed the relationship of recreational drug use patterns with negative drug use consequences, but this is the first time he has incorporated prescription opioids and other indicators of behavioral and mental health using nationally representative data.

“The results were consistent with previous research, but also show that there is a larger set of problems facing people who misuse prescription opioids,” explained Grigsby.

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