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October 15, 2012
1:00:00 PM - 4:00:00 PM
Room Hall C-Area J
Regional Variation in Prescription Medication Abuse and Illicit Drug Abuse
Mario Moric, M.S., Asokumar Buvanendran, M.D., Kenneth Tuman, M.D.
Rush University Medical Center, Chicago, Illinois, United States

Introduction: With the explosion of prescription drug abuse and fewer headlines referencing traditional illicit drugs, we examine prescription drug abuse profiles and traditional illicit drug abuse across the US, in an effort to identify possible relationships. The focus in the past few years, by the media, on prescription drug abuse has motivated the question as to whether this disparity in media coverage has any relation to abuse prevalence of the respective drug categories. Is there any correspondence between prescription drug abuse and illicit drug abuse? Is one taking the place of another? Are the populations of illicit drug abuse so different then illicit drug abuses that the trends are independent? These questions are difficult to answer but a good start would be to look at regional variations. Because of the wide heterogeneity of the US population, examining regional trends may elucidate patterns otherwise hidden on a national level.

Methods: Following IRB approval, survey data from the Drug Abuse Warning Network (DAWN) was imported into our database. The Drug Abuse Warning Network (DAWN) contains data on incidents of drug use derived from in-hospital emergency records and coroner s data. DAWN provides estimates of emergency department (ED) mentions (various drugs can be recorded for each visit) across the coterminous United States. To estimate prevalence the number of Emergency Department Mentions (EDM, i.e. visits to the emergency department), were extracted from the DAWN database. EDMs with indications of abuse of prescription medications (i.e. opioids) were extracted from the database over three years (2007 to 2009) and stratified by major metropolitan area (12 areas). Area can be considered a geographic region as the sampling method included all populations in the general vicinity. Additionally all EMDs related to illicit drug abuse (Heroin, Cocaine, etc.) were also examined as a useful comparator. Both EMDs are presented as a percentage of all EMDs for that Metro area.

Results: The figure represent two sets of data, one for the prescription abuse statistics for years 2007-2009 and the other of illicit drug over the same time periods. To assist interpretation, the data for the year 2007 was represented as a connected line. Examining the data (figure) we see that illicit drug abuse is consistently much higher in 2007 for each metro area except the Phoenix region. For illicit drug abuse (street drug abuse) the year 2008 trended lower (star) and 2009 trended lower than that (Circle), indicated a general decreasing abuse for all regions. On the other hand prescription drug abuse, bottom line, generally showed upward trends, although the increases are, in magnitude, not as large as the decreases in illicit drug abuse. Overall the percentage of EDMs for illicit drug abuse decreased (2007:36%, 2008:32%, 2009:28%) while prescription drug abuse EDMs increased (2007:20%, 2008:21%, 2009:22%)

Discussion: Although the trend seen for both illicit drug abuse and prescription drug abuse was in the direction we expected, the average decrease of about 4% a year for illicit drug abuse was larger than expected and the percentage increase for prescription drug abuse was smaller (about 1% increase a year), we don’t want to negate the seriousness of prescription drug abuse. This is only a first step to understanding the proliferation of drug abuse and we are in the progress of further refining the profile these populations.
Figure 1

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