Opioid and benzodiazepine use among a population-based cohort of adults with chronic spinal cord injury: Correspondence between self-report and state prescription monitoring data.

Abstract

Objective: To compare self-reported opioid and benzodiazepine use to rates of prescriptions dispensed among persons with chronic spinal cord injury (SCI), to evaluate the extent of potential underreporting.

Design: Cross-sectional self-report assessment (SRA) and retrospective review of prescription monitoring program (PMP) data.

Setting: Community dwelling adults in the Southeastern United States (US).

Participants: 345 adults (>18 years old) with chronic (>1 year) SCI who were identified through a state population-based SCI registry and who responded to SRA opioid use questions in a parent study.

Interventions: Not Applicable MAIN OUTCOME MEASURES: Self-reported prescription pain reliever, sedative, and tranquilizer use, and prescriptions dispensed based on PMP data. We compared self-reported past year utilization with records of dispensed prescriptions to assess potential underreporting, defined as reporting "never" using either opioids (pain relievers) or benzodiazepines (sedatives/tranquilizers) in the past year, but having had two or more respective prescriptions dispensed in the year prior to the SRA.

Results: Among the 345 participants who responded to the opioid use questions, we were able to match 252 to the PMP; reasons for not matching include not filling a controlled substance prescription in-state, either due to lack of reportable prescriptions or the prescription was dispensed out of state. Evaluating each prescription medication, rates of underreporting for each drug ranged from 0.4% - 4% for Hydrocodone, Oxycodone, Tramadol, Codeine, Buprenorphine and Hydromorphone. There was 100% agreement in the self-reported use and dispensed records for Fentanyl, Oxymorphone, Meperidine, and Methadone. The rates of potential underreporting of Benzodiazepines were less than 2%. Overall, of the 252 matched individuals, 11% underreported opioids (2 or more prescriptions dispensed) and 1% underreported benzodiazepines.

Conclusions: The findings suggest considerable agreement between self-reported and dispensed prescription medication use, and only minimal potential underreporting of select opioids and benzodiazepines, confirming the appropriateness of self-report of these prescription medications with people with SCI.