The prevalence of
illicit drug use by patients in a
chronic pain management practice who concomitantly abuse prescription-
controlled substances is not known. The purpose of this study was to determine the prevalence of
illicit drug use by patients in an interventional
pain management practice, based on whether or not there was evidence of simultaneous abuse of
prescription drugs. One hundred and fifty patients in an interventional
pain management practice who were prescribed
controlled substances for
pain treatment were selected for assessment of concomitant
illicit drug use by urine
drug testing. Patients were divided into two groups: Group I consisted of 100 consecutive patients without evidence of
controlled substance abuse and Group II consisted of 50 consecutive patients with documented abuse of prescription
controlled substances. All patients underwent urine testing with the Rapid
Drug Screen test. The test is a one-step, lateral flow immunoassay for the simultaneous detection of four
illicit drugs (i.e.,
amphetamine,
methamphetamine, marijuana, and
cocaine). Results showed a prevalence of
illicit drug abuse in patients without a history of
controlled substance abuse of 14%. In contrast,
illicit drug abuse in patients with a history of
controlled substance abuse was 34%. Marijuana was the
drug of choice in both groups, with 22% in the prescription abuse group and 10% in the non-abuse group. The second most commonly used
illicit drug in both groups was
cocaine. This study demonstrated a clinically significant use of
illicit drugs, particularly marijuana and
cocaine in an interventional
pain management setting, in patients with or without evidence of concomitant abuse of prescription
controlled substances.