Evaluating non-medical prescription opioid demand using commodity purchase tasks: test-retest reliability and incremental validity
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Non-medical prescription opioid use and opioid use disorder (OUD) present a significant public health concern. Identifying behavioral mechanisms underlying OUD will assist in developing improved prevention and intervention approaches. Behavioral economic demand has been extensively evaluated as a measure of reinforcer valuation for alcohol and cigarettes, whereas prescription opioids have received comparatively little attention.
Utilize a purchase task procedure to measure the incremental validity and test-retest reliability of opioid demand.
Individuals reporting past year non-medical prescription opioid use were recruited using the crowdsourcing platform Amazon Mechanical Turk (mTurk). Participants completed an opioid purchase task as well as measures of cannabis demand, delay discounting, and self-reported pain. A 1-month follow-up was used to evaluate test-retest reliability.
More intense and inelastic opioid demand was associated with OUD and more intense cannabis demand was associated with cannabis use disorder. Multivariable models indicated that higher opioid intensity and steeper opioid delay discounting rates each significantly and uniquely predicted OUD. Increased opioid demand intensity, but not elasticity, was associated with higher self-reported pain, and no relationship was observed with perceived pain relief from opioids. Opioid demand showed acceptable-to-good test-retest reliability (e.g., intensity rxx = .75; elasticity rxx = .63). Temporal reliability was lower for cannabis demand (e.g., intensity rxx = .53; elasticity rxx = .58) and discounting rates (rxx = .42–.61).
Opioid demand was incrementally valid and test-retest reliable as measured by purchase tasks. These findings support behavioral economic demand as a clinically useful measure of drug valuation that is sensitive to individual difference variables.
KeywordsBehavioral economics Cannabis Demand Discounting mTurk Opioid Pain Purchase task Reliability
This research was supported by the National Science Foundation Grant 1247392, a Graduate Student Research Grant from the Psi Chi Psychology Honor Society, and Professional Development Funds from the University of Kentucky Department of Behavioral Science. These funding sources had no role in study design, data collection or analysis, or preparation and submission of the manuscript. The authors have no financial conflicts of interest in regard to this research.
Compliance with ethical standards
The University of Kentucky Institution Review Board approved all procedures and participants reviewed an informed consent prior to participation.
- Center for Behavioral Health Statistics (2018) 2017 National Survey on drug use and health: detailed tables. Substance Abuse and Mental Health Services Administration, Rockville, MDGoogle Scholar
- Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR, Hillman D, Hon J, Hoover KW, Patel MR (2015) Community outbreak of HIV infection linked to injection drug use of oxymorphone--Indiana, 2015. MMWR Morb Mortal Wkly Rep 64:443–444Google Scholar
- Hedegaard H, Warner M, Miniño AM (2017) Drug overdose deaths in the United States, 1999–2016. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health StatisticsGoogle Scholar
- Sehgal N, Manchikanti L, Smith HS (2012) Prescription opioid abuse in chronic pain: a review of opioid abuse predictors and strategies to curb opioid abuse. Pain Physician 15:ES67–ES92Google Scholar
- Tsukayama E, Duckworth AL (2010) Domain-specific temporal discounting and temptation. Judgm Decis Mak 5:72–82Google Scholar
- Van Handel M, Rose CE, Hallisey EJ, Kolling JL, Zibbell JE, Lewis B, Bohm MK, Jones CM, Flanagan BE, Siddiqi A-E (2016) County-level vulnerability assessment for rapid dissemination of HIV or HCV infections among persons who inject drugs, United States. J Acquir Immune Defic Syndr 73:323–331CrossRefGoogle Scholar