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Data Sources Regarding the Nonmedical Use of Pharmaceutical Opioids in the United States

The following tables contain a categorization of existing data sources that pertain to nomedical use of pharmaceutical opioids in the United States. Four tables illustrate the relevance of these sources to salient topics regarding (1) nonmedical use, (2) diveresion, (3) adverse outcomes, and (4) design attributes. Row headings indicate salient topics within each of these areas, while column headings indicate the highest scale at which the data source is relevant. (Note that many sources also have more detailed information at smaller scales than are listed here.)

Within a table cell, each item (starting with "□") indicates a data source, followed by informational resources and example analyses for that source. Items without an explicit source name indicate lists of independent studies that have been conducted for a given topic and scale level. All sources that are publicly available are indicated in bold type font. All sources that imply pharmaceutical opioids without explicitly limiting responses to them (e.g., "pain killers", "pain medicine", or "narcotics other than heroin"), are followed directly by an asterisk.

Methodology
A list of keywords was created from an existing collection of electronic, journal article resources which had been used for a previous project. This list was simplified by omitting keywords of non-opioid drugs and substances, specific drug formulation names (e.g., Fentanyl, OxyContin), words pertaining spefically to medical treatment, and other words that were not directly related to the phenomena of interest (e.g., screening instrument, prevention, mental health, triplicates). The final list of keywords was grouped qualitatively into three PubMed searches, for (1) nonmedical use, (2) diversion, and (3) adverse outcomes.

Studies identified through these PubMed searches were filtered by three team members with a set of search criteria, requiring features such as peer review, English language, human subjects, quantitative data, a sample size minimum of 20 participants, and relevance to the US population. Articles that did not collect original data, but referred instead to previously existing data sources, were excluded but their data sources were noted.

The resultant list of 92 articles meeting all search criteria were evaluated qualitatively by two team members who independently created lists of most salient topics. The two lists were compared, and differences between them were resolved through discussion, resulting in the 22 topics listed in the tables below. The complete list of sources, including the 92 articles as well as other data sources identified in the filtering process, were then evaluated to identify the scale and relevance to each topic. Citations were identified to indicate all instances of membership in a table cell.

 

 SCALE
Topics Regarding Nonmedical UseNationalStateMulti CenterSingle Center
Individual Characteristics of those Exhibiting Abuse

DAWN [8], [9]
□ MTF* [1]
□ NAVIPPRO [10], [11], [12]
□ NESARC* [35], [36]
□ NLAES* [35]
NSDUH* [25], [26], [28], [37][42]
NVSS [43], [44]
TEDS [45], [46]
□ Toxicology [47]

□ CDAS* [2], [3], [4]
[48]
□ RADARS® [17], [29]
[49], [50], [51]*, [52], [53], [54], [30]
□ Treatment Centers [55][57]
[58], [59], [60], [61], [62], [63], [64], [65]
Social Characteristics of those Exhibiting Abuse □ NESARC* [66], [35]
□ NLAES* [35]
□ MTF* [1]
[67]
□ CDAS* [2], [3], [4] □ RADARS® [29]
[51]*, [50]
[64]
Routes of Administration □ MTF* [24]
□ NAVIPPRO [10], [11], [12]
□ NPDS [13][15]
NSDUH* [25], [68], [69]
  □ RADARS® [70]
[50], [53], [30]
[62], [65]
Motivations/Attitudes toward Nonmedical Use □ MTF* [1]   □ RADARS® [71]
[30]
[58], [22], [32], [62], [63]
Prevalence of Misuse/Abuse among Patients □ Toxicology [47]
[72]
  □ RADARS® [17], [73]
[49], [52], [54]
 
Prevalence of Nonmedical Use among Non-Patients DAWN [8], [9], [74]
□ MTF* [1], [24]
□ NAVIPPRO [10], [11], [12]
□ NESARC* [66], [35], [36]
□ NLAES* [35]
NSDUH* [25], [40], [42], [42]
[67]
□ CDAS* [2], [3], [4]
[48]
□ RADARS® [17], [73]
[75], [51]*, [53], [30]
[76], [31], [58], [77], [60], [32], [62], [65]
Initiation Rates of Nonmedical Use □ NAVIPPRO [10], [12]
□ NSDUH [25], [41], [78]
  □ RADARS® [17] [65]
Prevalence of Polydrug Use among Non-Patients DAWN [8], [9]
□ NAVIPPRO [10], [12]
  [53] [31], [60], [62], [61], [59], [65]
Frequency of Nonmedical Use □ MTF* [24]
NSDUH* [25], [38]
  [51]* [77], [60], [62]

 

 SCALE
Topics Regarding Adverse OutcomesNationalStateMulti CenterSingle Center
Prevalence of Fatal Opioid Overdose □ NPDS [13][15]
NVSS [43], [44], [93]
□ Medical Examiners [90], [94]   □ Medical Records [96]
Prevalence of Opioid Overdose □ NPDS [13][15], [81]
DAWN [8], [9], [97]
□ NIS [79], [80]
□ CDAS* [2], [3], [4]
□ Insurance Claims Data [89]
□ ACMT [98] □ Medical Records [96]
[64]
Prevalence of Substance Use Disorders □ NLAES* [35]
□ NESARC* [66], [35], [36]
NSDUH* [25], [26], [37], [38]
DAWN [8], [9]
□ NAVIPPRO [10], [11], [12]
□ VA Medical Records [84]
□ Treatment Centers [99]
□ CDAS* [2], [3], [4]
□ Insurance Claim Data [89]
  [77], [60], [62]
Suicide, Violence, Violent Suicide DAWN [8], [9]
□ NVDRS [100]
NVSS [43], [84]
     
Domestic Impact □ NPDS [13], [101]      
 Addiction Relapse □ NAVIPPRO [10], [11] [48]    

Note that topics listed regarding the adverse outcomes associated with pharmaceutical opioids do not necessarily indicate adverse outcomes caused by opioids.

 

 SCALE
Topics Regarding DiversionNationalStateMulti CenterSingle Center
Availability of Opioids □ MTF* [1] □ CDAS* [2], [3], [4] [5], [6], [7]  
Prescription Drug Post-Marketing Surveillance DAWN [8], [9]
□ NAVIPPRO [10], [11], [12]
□ NPDS [13], [14], [15]
     
Prescriptpion Drug Diversion by Healthcare Workers       □ Police Records [20]
[21], [22]
Sources of Prescription Drugs □ MTF* [23], [24]
□ NAVIPPRO [10], [11]
NSDUH* [25], [26][28]
□ CDAS* [2], [3], [4] □ RADARS® [17], [19], [29]
[7], [30]
[31], [32]
Controlled Substances Transactions and Tracking □ ARCOS [33], [34]      

 

 SCALE
Data Sources Categorized by Design AttributeNationalStateMulti CenterSingle Center
Geographic Trends in Opioid Abuse □ ARCOS [34]
DAWN [8], [9]
□ MTF* [1]
□ NAVIPPRO [10], [11], [12]
□ NIS [79], [80]
□ NPDS [13], [15], [81], [82]
NSDUH* [83]
NVSS [43], [44]
TEDS [45], [46]
□ VA Medical Records [84]
□ CDAS* [2], [3], [4]
□ Insurance Claims Data [85]
[75]
 
Longitudinal Trends in Opioid Abuse □ ARCOS [34]
DAWN [8], [9], [74]
□ MTF* [1]
□ NAVIPPRO [10], [11]
□ NESARC [66], [35]
□ NIS [79], [80]
□ NLAES [35]
NSDUH* [25], [86]
NVSS [43], [87]
TEDS [45], [46]
□ VA Medical Records [84]
[67]
□ CDAS* [2], [3], [4]
□ Insurance Claims [88], [89]
□ Medical Examiners [90]
[48]
□ RADARS® [91]
[53]
[92]
Acronyms Used: ACMT (American College of Medical Toxicology), ARCOS (Automation of Reports and Consolidated Order System), CDAS (Center for Drug and Alcohol Studies), DAWN (Drug Abuse Warning Network), MTF (Monitoring the Future), NAVIPPRO (National Addictions Vigilance Intervention and Prevention Program), NESARC (National Epidemiologic Survey on Alcohol and Related Conditions), NIS (Nationwide Inpatient Sample), NLAES (National Longitudinal Alcohol Epidemiology Survey), NPDS (National Poison Data System), NSDUH (National Survey on Drug Use and Health), NVDRS (National Violent Death Reporting System), NVSS (National Vital Statistics System), RADARS (Researched Abuse, Diversion and Addiction-Related Surveillance), TEDS (Treatment Episode Data Set), VA (Veterans Affairs)

Note that longitudinal data sources include cohort or panel studies as well as ‘repeated cross sectional’ studies.

 

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Recommended Citation:
Zimam, A., Schmidt, T., Nielsen, A., and Wakeland, W. (March, 2013). Data sources regarding the nonmedical use of pharmaceutical opioids in the United States [Online]. Available: http://www.pdx.edu/sysc/opioid-data-sources.

This work was completed under NIDA grant number 5R21DA031361-02.

Click here for a poster representation of this work, submitted to the College on Problems of Drug Dependence: http://www.pdx.edu/sysc/sites/www.pdx.edu.sysc/files/CPDD2013AZ.pdf