Table 2.
Association Between Non-Medical Use of Prescription Pain Medications and Emergency Department Utilization, NSDUH 2008–2013 (N=228,556)
| Past Year ED Utilization | ||||
|---|---|---|---|---|
| Unadjusted | Model 1 | Model 2 | Model 3 | |
| Odds Ratio, 95% CI | Adjusted OR, 95% CI | Adjusted OR, 95% CI | Adjusted OR, 95% CI | |
| Non-medical use of prescription pain medications | 1.69 (1.60–1.79) | 1.60 (1.52–1.70) | 1.45 (1.38–1.53) | 1.32 (1.24–1.41) |
| Age (years) | ||||
| 18–25 | REF | REF | REF | REF |
| 26–34 | 1.24 (1.20–1.28) | 1.25 (1.19–1.31) | 0.86 (0.82–0.90) | 0.85 (0.81–0.88) |
| 35–49 | 1.10 (0.96–1.05) | 1.10 (1.04–1.15) | 0.72 (0.69–0.76) | 0.71 (0.68–0.75) |
| 50+ | 0.86 (0.82–0.90) | 0.96 (0.92–1.01) | 0.74 (0.70–0.78) | 0.75 (0.71–0.78) |
| Male sex | 1.23 (1.19–1.28) | 1.17 (1.13–1.22) | 1.16 (1.12–1.20) | 1.18 (1.13–1.22) |
| Race/ethnicity | ||||
| White | REF | REF | REF | REF |
| Black | 1.65 (1.58–1.72) | 1.39 (1.33–1.45) | 1.42 (1.36–1.48) | 1.45 (1.39–1.51) |
| Hispanic | 0.99 (0.94–1.05) | 0.84 (0.80–0.89) | 0.84 (0.79–0.89) | 0.88 (0.83–0.93) |
| Other race | 0.76 (0.71–0.81) | 0.75 (0.70–0.80) | 0.74 (0.70–0.80) | 0.76 (0.71–0.82) |
| Insurance status | ||||
| Private | REF | REF | REF | REF |
| Medicare/Medicaid | 2.29 (2.18–2.40) | 1.67 (1.58–1.77) | 1.49 (1.40–1.58) | 1.46 (1.38–1.55) |
| Other insurance | 1.46 (1.38–1.55) | 1.27 (1.20–1.36) | 1.20 (1.12–1.28) | 1.18 (1.10–1.26) |
| Uninsured | 1.28 (1.23–1.33) | 1.01 (0.96–1.06) | 0.98 (0.93–1.03) | 0.95 (0.90–0.99) |
| High school graduate | 0.62 (0.59–0.64) | 0.77 (0.70–0.80) | 0.84 (0.80–0.88) | 0.86 (0.82–0.90) |
| Family income | ||||
| <$20,000 | REF | REF | REF | REF |
| $20,000–49,999 | 0.70 (0.67–0.72) | 0.86 (0.83–0.90) | 0.91 (0.87–0.95) | 0.91 (0.87–0.95) |
| $50,000–74,999 | 0.54 (0.52–0.57) | 0.75 (0.71–0.79) | 0.81 (0.77–0.86) | 0.82 (0.78–0.87) |
| >$75,000 | 0.44 (0.42–0.46) | 0.66 (0.62–0.69) | 0.73 (0.69–0.77) | 0.74 (0.70–0.78) |
| Unemployed | 1.34 (1.25–1.43) | 1.10 (1.03–1.17) | 1.16 (1.04–1.18) | 1.14 (1.09–1.19) |
| Good health status | 0.40 (0.39–0.42) | --- | 0.50 (0.48–0.52) | 0.51 (0.49–0.53) |
| Serious psych. distress | 2.13 (2.03–2.23) | --- | 1.67 (1.59–1.75) | 1.60 (1.53–1.68) |
| Substance use | ||||
| Other illicit SUD | 2.58 (2.22–3.00) | --- | --- | 1.41 (1.20–1.67) |
| Alcohol use disorder | 1.30 (1.23–1.38) | --- | --- | 1.09 (1.03–1.15) |
| Cannabis use disorder | 1.73 (1.58–1.89) | --- | --- | 1.07 (0.97–1.19) |
| Other prescription drug NMU | 1.56 (1.45–1.67) | --- | --- | 1.06 (0.96–1.16) |
| Nicotine dependence | 1.69 (1.63–1.76) | --- | --- | 1.29 (1.23–1.34) |
NSDUH=National Survey on Drug Use and Health; ED=Emergency Department; OR=odds ratio; CI=confidence interval; SUD=substance use disorder; NMU=non-medical use. Model 1 adjusted for age, gender, race/ethnicity, education, insurance, family income, employment, marital status, rural location, and survey year. Model 2 includes Model 1 plus self-rated health and past year serious psychological distress. Model 3 includes Model 2 plus abuse or dependence of alcohol, cannabis, and other illicit drugs (heroin, cocaine, hallucinogens and inhalants), non-medical use of other prescription medications, and nicotine dependence.