Profile of dependence symptoms among extramedical opioid analgesic users

Little is known about the extent of problems due to extramedical opioid analgesic use ('analgesic misuse') in the US general population. This study explores the distribution of the seven DSM-IV-defined past-year dependence symptoms in a total household sample of 7,810 past-year extramedical opioid analgesic users using the 2002-2003 National Survey on Drug Use and Health (NSDUH). We tested for differences in opioid analgesic dependence symptom profiles across four subgroups of opioid analgesic users, different levels of deviant behaviors, and presence/absence of serious mental health problems quantified by the Composite International Diagnostic Interview Short Form (CIDI-sf). Generalized Estimated Equations (GEE) models were used to analyze the data. The most common opioid analgesic dependence symptoms were 'tolerance' (17.0%) and 'salience' (13.3%). Opioid analgesic dependence symptom profiles were 'parallel' across the groups of past-year opioid analgesic users, across deviant behavior groups and across presence/absence of serious mental health problems. Extramedical use of opioid analgesics associated with prescription drug use, having high levels of deviant behaviors, and having serious mental health problems were more strongly associated with endorsement of opioid analgesics dependence symptoms.