Denial of prescription analgesia among people who inject drugs in a Canadian setting. (17th December 2014)

• Record Type: Journal Article
• Authors: Voon, Pauline; Callon, Cody; Nguyen, Paul; Dobrer, Sabina; Montaner, Julio S.G.; Wood, Evan; Kerr, Thomas
• Is Part Of: Drug and alcohol review. Volume 34:Number 2(2015)
• Page Start: 221
• Page End: 228
• Publication Date: 2014-12-17
• Subjects: Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drinking of alcoholic beverages -- Periodicals; 616.86
• DOI: 10.1111/dar.12226
• Languages: English
• ISSNs: 0959-5236

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="dar12226-sec-0001" sec-type="section"> <title>Introduction and Aims</title> <p>Despite the high prevalence of pain among people who inject drugs (PWIDs), clinicians may be reluctant to prescribe opioid‐based analgesia to those with a history of drug use or addiction. We sought to examine the prevalence and correlates of PWIDs reporting being denied of prescription analgesia (PA). We also explored reported reasons for and actions taken after being denied PA.</p> </sec> <sec id="dar12226-sec-0002" sec-type="section"> <title>Design and Methods</title> <p>Using data from two prospective cohort studies of PWIDs, multivariate logistic regression was used to identify the prevalence and correlates of reporting being denied PA. Descriptive statistics were used to characterise reasons for denials and subsequent actions.</p> </sec> <sec id="dar12226-sec-0003" sec-type="section"> <title>Results</title> <p>Approximately two‐thirds (66.5%) of our sample of 462 active PWIDs reported having ever been denied PA. We found that reporting being denied PA was significantly and positively associated with having ever been enrolled in methadone maintenance treatment (adjusted odds ratio 1.76, 95% confidence interval 1.11–2.80) and daily cocaine injection (adjusted odds ratio 2.38, 95% confidence interval 1.00–5.66). The most commonly reported reason for being denied PA was being accused of drug seeking (44.0%). Commonly reported actions taken after being denied PA included buying the requested medication off the street (40.1%) or obtaining heroin to treat pain (32.9%).</p> </sec> <sec id="dar12226-sec-0004" sec-type="section"> <title>Discussion and Conclusions</title> <p>These findings highlight the challenges of addressing perceived pain and the need for strategies to prevent high‐risk methods of self‐managing pain, such as obtaining diverted medications or illicit substances for pain. Such strategies may include integrated pain management guidelines within methadone maintenance treatment and other substance use treatment programs. <italic>[Voon P, Callon C, Nguyen P, Dobrer S, Montaner JSG, Wood E, Kerr T. Denial of prescription analgesia among people who inject drugs in a Canadian setting.</italic> Drug Alcohol Rev<italic> 2015;34:221–228]</italic></p> </sec> </abstract>