Prescription opioid use among addictions treatment patients: Nonmedical use for pain relief vs. other forms of nonmedical use

Abstract Background Differences between those who engage in nonmedical prescription opioid use for reasons other than pain relief and those who engage in nonmedical use for reasons related to pain only are not well understood. Methods Adults in a residential treatment program participated in a cross-sectional self-report survey. Participants reported whether they used opioids for reasons other than pain relief (e.g., help sleep, improve mood, or relieve stress). Within those with past-month nonmedical opioid use ( n = 238), logistic regression tested differences between those who reported use for reasons other than pain relief and those who did not. Results Nonmedical use of opioids for reasons other than pain relief was more common (66%) than nonmedical use for pain relief only (34%), and those who used for reasons other than pain relief were more likely to report heavy use (43% vs. 11%). Nonmedical use for reasons other than pain relief was associated with having a prior overdose (odds ratio [OR] = 2.54, 95% CI: 1.36–4.74) and use of heroin (OR = 4.08, 95% CI: 1.89–8.79), barbiturates (OR = 6.44, 95% CI: 1.47, 28.11), and other sedatives (OR = 5.80, 95% CI: 2.61, 12.87). Individuals who reported nonmedical use for reasons other than pain relief had greater depressive symptoms (13.1 vs. 10.5) and greater pain medication expectancies across all three domains (pleasure/social enhancement, pain reduction, negative experience reduction). Conclusions Among patients in addictions treatment, individuals who report nonmedical use of prescription opioids for reasons other than pain relief represent an important clinical sub-group with greater substance use severity and poorer mental health functioning.