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Quantifying morbidity associated with the abuse and misuse of opioid analgesics
A comparison of two approaches
Smith, M. Y., Schneider, M. F., Wentz, A., Hughes, A., Haddox, J. D., & Dart, R. (2007). Quantifying morbidity associated with the abuse and misuse of opioid analgesics: A comparison of two approaches. Clinical Toxicology, 45(1), 23-30. https://doi.org/10.1080/15563650600956170
BACKGROUND: Due to the rising nonmedical use of opioid analgesics, methods are needed to quantify the associated health-related consequences.
METHODS: Using opioid analgesic intentional exposure reports from poison control centers from January 2003-June 2004, we calculated quarterly rates for 7 opioids at the 3-digit ZIP code level using population- and patient-based denominators.
RESULTS: Hydrocodone was the most widely prescribed opioid (maximum: 5,321,390 patients per quarter), with the largest intentional exposure caseload (range: 498-1,290), and the highest aggregate population-based rate (maximum of 13.61 cases per 1,000,000 individuals). Methadone had the highest aggregate patient-based rate (maximum 2.03 cases per 1,000 patients).
CONCLUSION: Population- and patient-based rates are complementary tools that address different public health questions. Population-based rates describe the health-related burden of nonmedical opioid analgesic use on the community as a whole, while patient-based rates show this burden ("risk") in relation to the level of corresponding medicinal use ("benefit") within a given area.