Employment Status Influences Prescription Drug Misuse

How do you know if a patient is at a greater risk of misusing prescription painkillers? The US Food and Drug Administration (FDA) revised recommended questions to ask, but patient demographics and characteristics can also raise red flags.

Nonmedical prescription opioid use is when someone takes non-prescribed painkillers — commonly for the sensation. Misuse rates have declined in the United States in recent years, however, it remains a prominent public health issue. Employment status can be very telling for opioid and stimulant misuse odds, said researchers from Columbia University’s Mailman School of Public Health – who are among the first to evaluate the association in adults over the age of 25.

“Physicians, in particular, should be aware of patients’ employment status and the elevated risk between unemployment and nonmedical drug use and drug and mental disorders prior to prescribing,” senior author, Silvia Martins, MD, PhD, an epidemiologist and associate professor at the school, said in a news release.

Using data from the National Survey on Drug Use and Health, the team gathered information from 58,486 adults. Two multivariable logistic regression models were used and adjusted for sex, race, age, marital status, and psychological distress. Results were specified for nonmedical use of prescription opioid (NMUPO) and nonmedical use of prescription stimulants (NMUPS).

Generally, more people used nonmedical prescription opioids than stimulants (3.5% vs. 0.72%, respectively). Perhaps not so surprisingly, it was those who were unemployed who had the highest odds (7%) of NMUPO. But it was who were out of the workforce who had the highest odds (2%) of NMUPS. Either way, not currently working increased the odds of prescription misuse.

In addition, people who were only employed part-time had higher odds of NMUPS compared to those with full-time jobs.

“Our findings on these associations between employment status and nonmedical prescription drug use parallel other research about emerging adulthood and taking on new social roles, such as marriage and parenthood,” Martins explained.

According to an analysis in the Clinical Journal of Pain, nonmedical use of prescription opioids cost about $53.4 billion in the US in 2006. That cost was broken down to $42 billion (79%) for lost productivity, $8.2 billion (15%) for criminal justice costs, $2.2 billion (4%) for drug abuse treatment, and $944 million (2%) for medical complications. Two-thirds of the total burden was attributed to five prescription drugs — OxyContin, oxycodone, hydrocodone, propoxyphene, and methoadone.

Now that researchers uncovered this employment status-opioid misuse information, what’s next? Martins said that it can be used to better shape programs, “By improving our understanding of these associations and the role of employment in drug use behaviors and modes of access, drug prevention, and deterrence programs can target users more effectively, especially when combined with regulation.”

The full study, “Is employment status in adults over 25 years old associated with nonmedical prescription opioid and stimulant use?” is published in the journal Social Psychiatry and Psychiatric Epidemiology.

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