Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco.

Journal Article (Journal Article)

BACKGROUND: Current data suggest that opioid misuse or opioid use disorder (OUD) may be over represented among tobacco users. However, this association remains understudied in primary care settings. A better understanding of the extent of heterogeneity in opioid misuse among primary care patients who use tobacco may have implications for improved primary care-based screening, prevention, and intervention approaches. METHODS: Data were derived from a sample of 2000 adult (aged ≥18) primary care patients across 5 distinct clinics. Among past-year tobacco users (n = 882), we assessed the prevalence of opioid misuse and OUD by sociodemographic characteristics and past-year polysubstance use. Latent class analysis (LCA) was used to identify heterogeneous subgroups of tobacco users according to past-year polysubstance use patterns. Multinomial logistic regression was used to examine variables associated with LCA-defined class membership. RESULTS: Past-year tobacco use was reported by >84% of participants who reported past-year opioid misuse or OUD. Among those reporting past-year tobacco use, the prevalence of past-year opioid misuse and OUD was 14.0% and 9.5%, respectively. The prevalence of opioid misuse or OUD was highest among tobacco users who were male or unemployed. Three LCA-defined classes among tobacco users were identified including a tobacco-minimal drug use group (78.0%), a tobacco-cannabis use group (10.1%), and a tobacco-opioid/polydrug use group (11.9%). Class membership differed by sociodemographic characteristics. CONCLUSIONS: Results from this study support the benefit of more comprehensive assessment of and/or monitoring for opioid misuse among primary care patients who use tobacco, particularly for those who are male, unemployed, or polydrug users.

Full Text

Duke Authors

Cited Authors

  • John, WS; Zhu, H; Mannelli, P; Subramaniam, GA; Schwartz, RP; McNeely, J; Wu, L-T

Published Date

  • January 1, 2019

Published In

Volume / Issue

  • 194 /

Start / End Page

  • 468 - 475

PubMed ID

  • 30513477

Pubmed Central ID

  • PMC6329633

Electronic International Standard Serial Number (EISSN)

  • 1879-0046

Digital Object Identifier (DOI)

  • 10.1016/j.drugalcdep.2018.11.011


  • eng

Conference Location

  • Ireland