Since October 2002, physicians have been allowed to apply for waivers of the special registration requirements defined in the Controlled Substances Act to prescribe buprenorphine in treatment settings other than a traditional opioid treatment program.
“However, physicians have been reluctant to embrace this treatment option, possibly due to concerns regarding use of other illicit substances among patients who abuse pain relievers,” said Dr. Woodard of Baylor College of Medicine, Houston.
To estimate the prevalence of substance co-use among abusers of prescription analgesics, Dr. Woodard and her colleagues reviewed data from the 2000 National Household Survey on Drug Abuse, which showed that about 2.9% of Americans reported nonmedical use of pain relievers during the prior year, and 93% of those pain relievers were opioid analgesics.
Among users of prescription pain relievers, 23% reported heavy alcohol use, 46% reported using marijuana, and 46% reported co-using other illicit substances, Dr. Woodard reported at the annual meeting of the Society of General Internal Medicine.
Heavy use of alcohol was defined as having five or more drinks five times within the month prior to the survey. Rates for use of marijuana and other illicit substances were based on use during the year prior to the survey.
The investigators used logistic regression analysis to identify demographic factors associated with substance co-use in this population. The predictors considered were age, sex, race, education, employment, household income, veteran status, and metropolitan statistical area. “Controlling for other predictors in the model, age, race, and marital status were all broadly associated with heavy alcohol, marijuana, or other illicit substance co-use,” Dr. Woodard said.
People aged younger than 50 years were significantly more likely to be co-users of all three types of substances than were those older than 50; white individuals were significantly more likely to co-use all three types compared with individuals of other races/ethnicities; and single people were significantly more likely than were those who were married to co-use all three types.
Men were significantly more likely than were women to co-use heavy alcohol and marijuana, and college-educated individuals were significantly more likely than were their less-educated counterparts to co-use the other illicit substances.