Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco.

John, William S

Zhu, He

Mannelli, Paolo

Subramaniam, Geetha A

Schwartz, Robert P

McNeely, Jennifer

Wu, Li-Tzy

2020-02-03T03:51:33Z

2020-02-03T03:51:33Z

2019-01

2020-02-03T03:51:31Z

BACKGROUND:Current data suggest that opioid misuse or opioid use disorder (OUD) may be over represented among tobacco users. However, this association remains understudied in primary care settings. A better understanding of the extent of heterogeneity in opioid misuse among primary care patients who use tobacco may have implications for improved primary care-based screening, prevention, and intervention approaches. METHODS:Data were derived from a sample of 2000 adult (aged ≥18) primary care patients across 5 distinct clinics. Among past-year tobacco users (n = 882), we assessed the prevalence of opioid misuse and OUD by sociodemographic characteristics and past-year polysubstance use. Latent class analysis (LCA) was used to identify heterogeneous subgroups of tobacco users according to past-year polysubstance use patterns. Multinomial logistic regression was used to examine variables associated with LCA-defined class membership. RESULTS:Past-year tobacco use was reported by >84% of participants who reported past-year opioid misuse or OUD. Among those reporting past-year tobacco use, the prevalence of past-year opioid misuse and OUD was 14.0% and 9.5%, respectively. The prevalence of opioid misuse or OUD was highest among tobacco users who were male or unemployed. Three LCA-defined classes among tobacco users were identified including a tobacco-minimal drug use group (78.0%), a tobacco-cannabis use group (10.1%), and a tobacco-opioid/polydrug use group (11.9%). Class membership differed by sociodemographic characteristics. CONCLUSIONS:Results from this study support the benefit of more comprehensive assessment of and/or monitoring for opioid misuse among primary care patients who use tobacco, particularly for those who are male, unemployed, or polydrug users.

S0376-8716(18)30600-8

0376-8716

1879-0046

https://hdl.handle.net/10161/19926

eng

Elsevier BV

Drug and alcohol dependence

10.1016/j.drugalcdep.2018.11.011

Humans

Opioid-Related Disorders

Prevalence

Marijuana Smoking

Adolescent

Adult

Middle Aged

Primary Health Care

Female

Male

Young Adult

Tobacco Use

Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco.

Journal article

Mannelli, Paolo|0000-0002-7834-6138

Wu, Li-Tzy|0000-0002-5909-2259

468

475

School of Medicine

Duke

Center for Child and Family Policy

Sanford School of Public Policy

Duke Clinical Research Institute

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Psychiatry & Behavioral Sciences

Clinical Science Departments

Medicine, General Internal Medicine

Medicine

Staff

Published

194