The Relationship Between Non-Medical Use of Prescription Opioids and Sex Work Among Adults in Residential Substance Use Treatment

Highlights

• Sex work (SW) is common among patients in residential substance use treatment.
• SW among individuals in addictions treatment is associated with more extensive substance use and greater psychiatric severity.
• Non-medical use of prescription opioids is widespread among individuals involved in SW.

High rates of substance use (e.g., alcohol, cocaine, heroin) have been documented among individuals who engage in sex work (SW), and adults seeking substance use disorder (SUD) treatment frequently report prior engagement in SW. Non-medical use of prescription opioids (NMUPO) has increased over the last decade, but little is known about the relationship between NMUPO with sex exchange. 

The purpose of this study was to describe the prevalence of recent SW among patients at a large residential SUD treatment center and examine the association between NMUPO and SW. Approximately 14% of 588 adults reported involvement in SW in the month prior to treatment. NMUPO was more common among those with a history of SW (95% of sex workers vs. 74% of non-sex-workers), and this association remained statistically significant after controlling for demographic factors, other substance use and psychiatric symptom severity (odds ratio=3.38). SW is relatively common among patients in residential SUD treatment, and is associated with greater psychiatric severity and more extensive substance use, including alarming rates of NMUPO. 

Addiction treatment for individuals involved in SW may benefit from the addition of content related to NMUPO.

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By:  Matusiewicz AK1, Ilgen MA2, Bonar EE3, Price A3, Bohnert AS2.

• VA Center for Clinical Management Research (CCMR), 2800 Plymouth Rd. Building 16, Ann Arbor MI 48109 USA; Department of Psychiatry, University of Michigan, 2800 Plymouth Rd. Building 16, Ann Arbor MI 48109 USA; VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor MI 48109 USA. Electronic address: amatusie@uvm.edu.
• 2VA Center for Clinical Management Research (CCMR), 2800 Plymouth Rd. Building 16, Ann Arbor MI 48109 USA; Department of Psychiatry, University of Michigan, 2800 Plymouth Rd. Building 16, Ann Arbor MI 48109 USA.
• 3Department of Psychiatry, University of Michigan, 2800 Plymouth Rd. Building 16, Ann Arbor MI 48109 USA. 
• J Subst Abuse Treat. 2016 May;64:24-8. doi: 10.1016/j.jsat.2016.01.010. Epub 2016 Feb 13.

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