Quantifying morbidity associated with the abuse and misuse of opioid analgesics: A comparison of two approaches

Meredith Y. Smith, Michael F. Schneider, Alicia Wentz, Alice Hughes, J. David Haddox, Richard Dart

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background. Due to the rising nonmedical use of opioid analgesics, methods are needed to quantify the associated health-related consequences. Methods. Using opioid analgesic intentional exposure reports from poison control centers from January 2003-June 2004, we calculated quarterly rates for 7 opioids at the 3-digit ZIP code level using population- and patient-based denominators. Results. Hydrocodone was the most widely prescribed opioid (maximum: 5,321,390 patients per quarter), with the largest intentional exposure caseload (range: 498-1,290), and the highest aggregate population-based rate (maximum of 13.61 cases per 1,000,000 individuals). Methadone had the highest aggregate patient-based rate (maximum 2.03 cases per 1,000 patients). Conclusion. Population- and patient-based rates are complementary tools that address different public health questions. Population-based rates describe the health-related burden of nonmedical opioid analgesic use on the community as a whole, while patient-based rates show this burden ("risk") in relation to the level of corresponding medicinal use ("benefit") within a given area.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalClinical Toxicology
Issue number1
StatePublished - Jan 2007


  • Denominator
  • Drug abuse rates
  • Intentional exposure
  • Opioid analgesic abuse and morbidity
  • Poison control centers

ASJC Scopus subject areas

  • Toxicology


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