Abstract
BACKGROUND: There are no population-based studies of emergency department (ED) utilization by individuals using prescription pain medications non-medically. We examined whether non-medical use of prescription pain medications was independently associated with increased ED utilization. METHODS: We conducted a retrospective analysis of a nationally representative sample of the non-institutionalized, civilian U.S. population in the National Survey on Drug Use and Health, 2008-2013. We used multivariable logistic regression to examine the association between past year ED utilization and non-medical use of prescription pain medications, defined as use of medications "not prescribed for you or that you took only for the experience or feeling they caused". RESULTS: An estimated 10.5 million adults annually reported past year non-medical use (NMU) of prescription pain medications, and 39%, or 4.1 million adults annually, also reported one or more past year ED visits. After adjustment for sociodemographic and clinical characteristics, adults with past year NMU of prescription pain medications had increased odds of past year ED utilization (adjusted odds ratio 1.32; 95% confidence interval 1.24-1.41). In secondary analyses, individuals with more frequent NMU had increased odds of ED utilization in unadjusted analyses, but this association was attenuated with adjustment for the source of prescription pain medication (i.e., physician, friend/family, other source). CONCLUSIONS: Non-medical use of prescription pain medications is associated with increased ED utilization. Further work is needed to identify the optimal role of ED settings in providing screening, education, and treatment referral for individuals using prescription pain medications non-medically.