Validity of Self-Reported Misuse of Prescription Opioid Analgesics

Abstract

Aim: To determine concurrent validity of self-reported misuse of prescription opioids. Design and Setting: Cross-sectional study in five U.S. methadone maintenance programs. Participants: 92 addicts. Measurements: Self-reported questionnaire assessing past-month misuse of 14 opioid analgesics, and color photographs of five opioid analgesics with instructions to mark those used in the past month “to get high.” Concordance between self-report and photograph endorsement was assessed via Kappa statistic. Findings: 29 respondents completed both questionnaire and photograph endorsements. Kappas were 0.62 (OxyContin®), 0.59 (methadone), 0.49 (Dilaudid®), and 0.46 (generic extended-release oxycodone). Conclusions: Good-to-fair concurrent validity of self-reported abuse was seen for OxyContin®, methadone, Dilaudid®, and generic extended-release oxycodone.

Keywords :

• validity
• self-reported drug misuse
• opioid analgesic abuse
• OxyContin®
• Dilaudid®

THE AUTHORS

Meredith Smith is Senior Scientific Director, Risk Management for Pain Care and Immunology Development at Abbott Laboratories. Previously, Dr. Smith was at Purdue Pharma L.P. where she was Director of Risk Management for four years. Prior to joining industry, Dr. Smith held faculty appointments at New York University, Memorial-Sloan Kettering Cancer Center, and Mount Sinai School of Medicine where she was principal investigator on research studies examining psychosocial adjustment, quality of life outcomes, healthcare utilization, and doctor-patient communication in cancer and HIV patients with funding from the American Cancer Society, NIH, AHRQ, and the Susan B. Komen Breast Cancer Foundation. Dr. Smith holds a doctorate in health services research from the Robert Wagner School of Public Service, New York University. Prior to receiving her doctorate Dr. Smith worked at the federal Centers for Disease Control and Prevention and the New York City Health Department.

Andrew Rosenblum is the director of the Institute for Treatment and Services Research at the National Development and Research Institutes, Inc (NDRI). He has a doctorate in social-personality psychology from the Graduate Center of the City University of New York and has been conducting addiction and related research for the past 20 years. Among his current projects are: a nationwide survey on prescription drug abuse, a clinical trial on the use of sublingual buprenorphine to treat chronic pain, and a multisite randomized clinical trial to determine the efficacy of “dual focus” 12-step mutual aid groups for person with co-occurring substance use and mental disorders. Other research interests include agonist therapy (buprenorphine, methadone) for opioid addiction and cognitive behavioral therapy.

Mark W. Parrino, M.P.A., has been involved in the delivery of health care and substance abuse treatment since 1974. He received both a Baccalaureate in Psychology (1974) and a Masters in Health Policy, Planning and Administration (1982) from New York University. Mr. Parrino served as the Director of the Gramercy Park Medical Group, an outpatient methadone treatment program, from 1980 to 1994. He also served as President of the National Development and Research Institutes, Inc. (NDRI) and was the Chair of New York City's Health Systems Agency's Technical Advisory Group on Substance Abuse. Mr. Parrino served as the Chair of the Center for Substance Abuse Treatment (CSAT) Consensus Panel for State Methadone Treatment Guidelines, the first Treatment Improvement Protocol (TIP) published for national distribution. Currently, Mr. Parrino is the President of the American Association for the Treatment of Opioid Dependence and continues to be responsible for the development and implementation of the Association's organizing initiatives. He is a consultant and educator to government, community, and business groups concerning substance abuse treatment and policy. Mr. Parrino is a recipient of the Robert Wood Johnson Foundation Innovators Award for 2003.

Chunki Fong, M.S., is the Data Manager & Analyst for the Institute for Treatment and Services Research and the Senior Methodologist for the Center for Therapeutic Community Research at NDRI. With his background in Statistics and Computer Science, he conducts research and data analysis and provides technical support for various substance abuse research projects at NDRI. Mr. Fong has been involved in projects that dealt with peer mentoring for HIV-affected high risk youth, the prevalence of prescription opioid abuse among methadone treatment enrollees, a clinical trial comparing buprenorphine and methadone for jailed opioid-addicted inmates, a study of juvenile drug abusing offenders, and an evaluation of case management for homeless drug abusers receiving services from a medical van. Prior to joining NDRI in 1999, Mr. Fong provided research support for a Workers Compensation Rating Bureau and served as SAS statistical programmer in an institute for home visiting service. Mr. Fong received a Bachelor of Art degree for Math & Computer Science at Queens College and a Masters of Science degree for Applied Statistics at Baruch College, both at the City University of New York.

Salvatore v. Colucci is the Director of Biostatistics for Purdue Pharma, with responsibilities for statistical design and analysis of Phase 1 studies. Sal has been a statistician in the pharmaceutical industry for over 25 years. Prior to working with Purdue Pharma, Mr. Colucci was the owner of a Contract Research Organization that provided data management and statistical services to support/sponsor clinical trials. Mr. Colucci has taught undergraduate statistics at the University of Connecticut and Rutgers University.

Notes

1 The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.