Prescription Opioid Availability and Risk for Initiation in Household Members

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The 1-year estimated risk for initiating opioids in individuals with a household member with an opioid prescription was found to be 11.83%.
The 1-year estimated risk for initiating opioids in individuals with a household member with an opioid prescription was found to be 11.83%.

Availability of prescription opioids in the household may increase the risk for opioid initiation in co-residents, according to a retrospective study published recently in JAMA Internal Medicine.

In this cohort study, researchers compared a total of 12,695,280 commercial insurance beneficiaries who had been exposed to opioids through a household member with 6,359,639 insurance beneficiaries sharing a household with individuals taking nonopioid pain relievers (ie, nonsteroidal anti-inflammatory drugs [NSAIDs]) during 2000 to 2014.

The 1-year estimated risk for initiating opioids in individuals with a household member with an opioid prescription was found to be 11.83% (95% CI, 11.81%-11.85%) vs 11.11% (95% CI, 11.09%-11.14%) in individuals exposed to NSAIDs. In these 2 groups, the overall risk difference was 0.71% (95% CI, 0.68%-0.74%).

Risk differences for opioid initiation in adults age 18 to 25 was 0.91% (95% CI, 0.81%-1.01%) vs 1.26% (95% CI, 1.08%-1.43%) for individuals age 26 to 35. Also, the risk difference for individuals in western United States was 0.95% (95% CI, 0.88%-1.02%) compared with 0.44% (95% CI, 0.38%-0.51%) in north central United States.

The investigators were unable to validate the co-residence status of household members, and were not able to verify other sources of opioid medications household members could have been exposed to prior to or during the study period. Misrepresentation and misclassification of individuals' opioid exposure history could have introduced prevalent user bias.

In an effort to combat the present opioid epidemic, the researchers recommend “comprehensive solutions for all aspects contributing to this public health issue, including the potential for medication sharing and other unintended consequences of prescription opioid use in households.”

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Reference

Seamans MJ, Carey TS, Westreich DJ, et al. Association of household opioid availability and prescription opioid initiation among household members. JAMA Intern Med. 2018;178(1):102-109.

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