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APHA Scientific Session and Event Listing

Caleb Banta-Green, MPH MSW¹, Joseph Merrill, MD MPH², Barry Logan, PhD³, Richard Harruff, MD PhD⁴, Ann Marie Gordon, MA³, and Sara Miller, MPH¹. (1) Alcohol and Drug Abuse Institute, Univ of Washington, 1107 NE 45th St, Suite120, seattle, WA 98105, 2066853919, calebbg@u.washington.edu, (2) Harborview Medical Center, 325 Ninth Ave., seattle, WA 98104, (3) Forensic Lab Services Bureau, WA State Patrol, 2203 Airport Way S, Suite 360, seattle, WA 98134, (4) Medical Examiner's Office, 325 Ninth Ave., seattle, WA 98104

Over the last 20 years substantial efforts have been made to increase the use of prescription-type opiates as one method of improving pain management. Prescriptions for opiates and indictors of morbidity and mortality associated with prescription-type opiates have increased significantly in the last decade nationally and in Washington State. The degree to which the increasing use of prescription-type opiates is a problem or represents an improvement in pain management depends on the nature and interpretation of available data. Interpretation is challenging due to the complexity of defining and measuring pain, misuse and addiction. The objective of this analysis is to discern the proportion of the increase in indicators that is likely due to misuse versus appropriate use of prescription-type opiates in Seattle-King County. Sources for chronic pain prevalence (CDC BRFSS), prescription-type opiate use (DEA), misuse (household surveys, DUI rates, law enforcement seizures), morbidity (ER visits, poison control center and drug treatment admissions), and mortality (medical examiner) covering the past 5-10 years are examined. These indicator data are examined in the context of two recent investigations by the authors into prescription-type opiate involved mortality and prescription-type opiate use among clients entering methadone treatment for opiate addiction. Results indicate that some of the increase in indicator data that has been attributed to misuse is in fact due to increasing prevalence of appropriate use. Many of the methods utilized can be replicated by other regions. Implications of these findings for public health, medical practice and prescription regulations are presented.

Learning Objectives:

1.Identify key data sources for opiate misuse epidemiology
• Describe the strengths and weaknesses of these data sources
• Describe the degree to which indicators of opiate use represent misuse versus appropriate use

Keywords: Drug Abuse, Epidemiology

Related Web page: depts.washington.edu/adai/wa/

Presenting author's disclosure statement:

Not Answered