Factors in Choice of Opioid for Abuse Analyzed

(HealthDay News) – The choice of hydrocodone vs. oxycodone as a primary drug of abuse is based on multiple factors, according to a study published in the December issue of PAIN.

Theodore J. Cicero, PhD, from Washington University in St. Louis, and colleagues conducted anonymous surveys and interviews to determine drug use pattern and decision-related factors for primary opioid selection in 3,520 opioid-dependent subjects entering one of 160 drug treatment programs.

The researchers found that the drugs of choice were oxycodone and hydrocodone for 75% of all patients. Significantly more users chose oxycodone (44.7%) than hydrocodone (29.4%), mainly because the quality of the high was viewed to be superior (54% in oxycodone users vs. 20% in hydrocodone users). Acetaminophen was cited as a deterrent to dose escalation to get high for hydrocodone users. Risk-averse women, elderly people, noninjectors, and those who prefer safer modes of acquisition than dealers (such as doctors, friends, or family members) generally chose hydrocodone. Oxycodone was preferred by risk-tolerant young, male users who prefer to inject or snort their drugs and are prepared to use more aggressive forms of diversion.

"Prevention and treatment approaches, and pain physicians, should benefit from these results because it is clear that not all drug abusers share the same characteristics, and the decision to use one drug over another is a complex one," write the authors.

Two authors report ties to a nonprofit postmarketing surveillance system with links to the pharmaceutical industry.

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