• Martha J Wunsch, Karen L Cropsey, Eleanor D Campbell, and Janet S Knisely.
• Addiction Medicine, Edward Via Virginia College of Osteopathic Medicine, Blacksburg, VA, USA.
• J Opioid Manag. 2008 Mar 1; 4 (2): 73-9.

ObjectiveThis study was designed to describe and compare individuals in rural Appalachia prescribed, abusing or diverting OxyContin a region with high rates of prescription medication abuse and misuse.Setting And ParticipantsFifty subjects treated for OxyContin abuse, 34 subjects prescribed OxyContin for pain and 50 subjects incarcerated due to OxyContin-related charges from rural Appalachia.InterventionsThe Addiction Severity Index, DSM-IV Checklist, and an investigator developed questionnaire were administered to all three groups.ResultsAll three groups included individuals prescribed OxyContin for pain and demographic variables and psychiatric/medical histories failed to discriminate between the pain and substance abuse (SA) subjects. SA and criminal justice subjects were significantly more likely to have a current DSM-IV diagnosis ofpsychoactive abuse/dependence and more likely to be younger and unmarried.ConclusionThis study found that these groups are not distinct and in depth evaluations, including a detailed SA history, are needed to identify the pain patient at risk for abuse and/or diversion of prescribed opioids.

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