Factors associated with prescription pain reliever misuse: An analysis of statewide data

Objectives: Characterize the individual-level risk factors associated with recent prescription pain reliever misuse (PPRM). Design: A multivariable logistic regression was developed with 21 covariates. Setting and participants: The 2015 Ohio Medicaid Assessment Survey (OMAS) was analyzed. The 2015 OMAS was a complex-designed representative survey of all adult Ohioans, regardless of Medicaid status (n = 42,876). Outcome measures: The main outcome was PPRM within the past year ("yes" vs. "no"). Results: An estimated 2.75% of adults in Ohio reported PPRM in the past year (approximately 242,232 individuals). The regression model identified 11 covariates with significantly higher odds of PPRM within the past year. The 5 covariates with the largest, significant effect sizes were binge drinking habits (adjusted odds ratio [AOR] for binge drinking in the past month: 2.35, 95% CI 1.97-2.81; AOR for drinking in the past month but no bingeing: 1.43, 95% CI 1.22-1.67), did not get medical examination, medical supplies, mental health care, or eyeglasses in the past year because of cost (AOR 1.74, 95% CI 1.44-2.11), no insurance (AOR 1.67, 95% CI 1.15-2.45), emergency room visits in the past year (AOR 1.66, 95% CI 1.42-1.93), and had problems paying medical bills in the past year (AOR 1.52, 95% CI 1.29e1.80). Conclusion: In this cross-sectional study of 42,847 adult Ohioans, the covariates associated with PPRM in the past year were identified and quantified. The significant covariates can be broadly grouped into substance use history, poor health care access, demographic characteristics, and chronic health conditions. The single covariate with the largest effect size was binge drinking in the past month; those individuals were more than twice as likely to have endorsed PPRM in the past year compared with those who did not drink at all in the past month. (C) 2019 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.