Gender differences in diversion among non-medical users of prescription opioids and sedatives

ABSTRACT

Background

Non-medical use of prescription drugs is a major public health concern in the United States. Prescription opioids and sedatives are among the most widely abused drugs and their combined use can be lethal. Increasingly rigid prescribing guidelines may contribute to the changing context of opioid use and increase drug diversion.

Objective

To examine gender differences in diversion of prescription opioids and sedatives among non-medical prescription opioid and sedative polysubstance users. We hypothesize that men will be more likely than women to engage in incoming diversion.

Methods

Data from the Prescription Drug Abuse, Misuse, and Dependence Study, a cross-sectional study focused on prescription drug users, were analyzed. Non-medical use was defined as use of a drug that was not prescribed or use in a way other than prescribed. Individuals who reported past 12-month non-medical opioid and sedative use were included; diversion was defined as incoming (obtaining drugs from a source other than a health professional) and outgoing (giving away/selling/trading prescription drugs).

Results

Among the 198 polysubstance users, 41.4% were female. Men were 2.85 times as likely as women to report incoming diversion (95% CI: 1.21–6.72). Women were more likely to obtain opioids from a healthcare professional; men were more likely to obtain sedatives from a roommate, coworker, or friend. Over half of men and women reported outgoing diversion opioids or sedatives.

Conclusion

Drug diversion highlights an important point of intervention. Current prevention efforts that target prescribers should be expanded to include users and diversion activities; these interventions should be gender-specific.

KEYWORDS:

• Prescription pain relievers
• opioids
• sedatives
• benzodiazepines
• non-medical use
• diversion
• misuse

Acknowledgements

This study (Prescription Drug Misuse, Abuse, and Dependence study) was supported by the National Institute on Drug Abuse Grant (R01DA020791; LB Cottler, PI). S.A.M. is currently funded through the training grant #T32AG000270 (PI Wong) from the National Institute on Aging/National Institutes of Health. She was also funded for a portion of this work through the Graduate School Fellowship at the University of Florida. SLL is funded by the National Institute on Drug Abuse T32 training grant at the UF Substance Abuse Training Center in Public Health from the National Institutes of Health (T32DA035167). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH..

Disclosures

Drs. Cottler and Striley have received funding from Arbor Pharmaceuticals LLC.

Additional information

Funding

This work was supported by the National Institute on Aging [T32AG000270]; National Institute on Drug Abuse [R01DA020791,T32DA035167].