Severity of opioid dependence: Figure 3 shows the number and type of DSM-III-R criteria for opioid dependence met by patients. Forty-six patients (79%) met more than seven DSM-III-R criteria, and 43% met all nine. This finding, interpreted together with the fact that hospital admission was required due to their opioid dependence, indicates the severity of patients’ problems with drugs at the time of in-patient treatment.

Figure3Severe dependence on oral opiods

Figure 3) Top Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria for current opioid dependence and percentage of patients who met criteria. Bottom Proportion of opioid-dependent patients who met three to five, six, seven or eight DSM-III-R criteria for current opioid dependence 

Most frequently used opioids

Many patients used more than one opioid; however, the product that they used most frequently at the time of admission was considered their primary opioid. Codeine (either over-the-counter or prescription) was the primary opioid for most patients (51.7%). Oxycodone was the primary opioid for 39.7% of patients, while hydromorphone and morphine were the primary opioid for fewer patients (6.9% and 1.7%, respectively). flovent inhaler

The doses of opioids used were far higher than those usually recommended for therapeutic purposes (daily dose of 60 mg codeine or equivalent). Mean dally dose for all patients (in codeine equivalents) was 976 mg/day. Codeine daily dose was 554+343 mg (mean± SD, range 120 to 1500 mg). This dose was significantly lower than the oxycodone daily dose (1265+1377 mg/day, range 333 to 6670 mg, in codeine equivalents, P<0.01). The mean duration of opioid use at the current dose was 81 months (range seven to 330 months). Twenty-two per cent of patients used opioids initially to treat headaches or migraines, and 50% of patients used opioids to treat other pain.