BOSTON GLOBE/HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH PRESCRIPTION PAINKILLER ABUSE: U.S. ATTITUDES

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1 BOSTON GLOBE/HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH PRESCRIPTION PAINKILLER ABUSE: U.S. ATTITUDES This survey was conducted for the Boston Globe and the Harvard T.H. Chan School of Public Health via telephone by SSRS, an independent research company. Interviews were conducted by telephone (landline and cell phone) from April 15-19, 2015, among a nationally representative sample of 1,033 respondents age 18 or older. The margin of error for total respondents is +/-3.6 percentage points at the 95 confidence level. I. Perceived Seriousness of the Problem and General Concern Q1. How serious do you think the following problems are in the state of [name of state]? How about abuse of (INSERT ITEM)? Do you think that is an extremely serious problem in [name of state], very serious, somewhat serious, not too serious, or not a problem at all? a. Heroin Extremely serious 19 Very serious 26 Somewhat serious 23 Not too serious 13 Not a problem at all 6 Don t know/refused 13 (Asked of random half sample; n=502) c. Alcohol Extremely serious 13 Very serious 28 Somewhat serious 32 Not too serious 17 Not a problem at all 5 Don t know/refused 5 1

2 (Asked of random half sample; n=531) d. Marijuana Extremely serious 9 Very serious 18 Somewhat serious 22 Not too serious 26 Not a problem at all 21 Don t know/refused 4 e. Strong prescription painkillers, such as Percocet, OxyContin or Vicodin Extremely serious 21 Very serious 30 Somewhat serious 27 Not too serious 10 Not a problem at all 3 Don t know/refused 9 When we ask about prescription painkillers in this poll, we mean strong ones, sometimes called opioids, such as Percocet, OxyContin or Vicodin. (Asked of random half sample; n=518) Q2. Do you believe the problem of prescription painkiller abuse in [name of state] is better, worse, or about the same as it was 5 years ago? Better 9 Worse 39 Same 38 Don t know/refused 14 Q3. How likely do you think it is that a person taking a strong prescription painkiller will become addicted to it? Very likely 44 Somewhat likely 36 Somewhat unlikely 12 Very unlikely 5 Don t know/refused 3 2

3 (Asked of random half sample; n=515) Q4. Do you think prescription painkiller abuse makes a person more likely or less likely to use heroin or other illegal drugs, or do you think it doesn t make much of a difference? More likely 50 Less likely 3 Doesn t make much of a difference 40 Don t know/refused 7 Q4a.To the best of your knowledge, is there a treatment for prescription painkiller addiction that is effective for a long period of time, or isn t there such a treatment? Yes, there is a treatment 45 No, there is not a treatment 28 Don t know 27 3

4 II. Personal Experience Many people take prescription painkillers for health problems they have. Q5. During the past 2 years, have you taken any strong prescription painkillers, such as Percocet, OxyContin, or Vicodin, prescribed by a doctor for you to use for more than a few days, or not? Yes 21 No 79 Refused -- (Asked of respondents who took strong prescription painkillers; n=216) Q6. Before or while you were taking these strong prescription painkillers, did you and your doctor talk about the risk of prescription painkiller addiction, or haven t you talked about that? Yes, talked about the risk 61 No, did NOT talk about the risk 39 Don t know/refused -- (Asked of respondents who took strong prescription painkillers; n=216) Q7. When you were taking these strong prescription painkillers, were you concerned that taking them could lead you to become addicted, or weren t you concerned with that? (If CONCERNED ASK:) Were you very concerned, somewhat concerned, or not too concerned? Very concerned 16 Somewhat concerned 10 Not too concerned 7 Not concerned 67 Don t know/refused -- 4

5 (Asked of respondents who took strong prescription painkillers; n=216) Q8. Some people save strong prescription painkillers after the prescribed length of time in case they or a family member need them for another health problem in the future. Have you saved any of these strong prescription painkillers to use later on, or is this something you haven t done? Yes, have saved strong prescription painkillers to use later on 17 No, have not done this 83 Don t know/refused * (Asked of respondents who took strong prescription painkillers; n=216) Q9. Some people have reported that they believe other people have used or taken some of their prescription painkillers. In the past 2 years, have you known or suspected that someone else was using, taking, or selling your strong prescription painkillers, or haven t you thought this? Yes 12 No 88 Don t know/refused -- 5

6 III. Rx Painkiller Abuse Problems among People You Know Q10. During the past 5 years, have you known anyone who has abused prescription painkillers, or not? Yes 39 No 61 (Asked of respondents who knew someone who has abused prescription painkillers; n=387) Q11. Do you believe that person s abuse of prescription painkillers led to their using heroin or other illegal drugs, or don t you believe it did? Yes 43 No 51 Don t know/refused 6 Q12. Did that person s abuse of prescription painkillers have a harmful effect on (INSERT ITEM), or not? Did it have a harmful effect on (next item), or not? (IF HARMFUL EFFECT ASK:) Did it have a major or minor harmful effect? (Asked of respondents who knew someone who has abused prescription painkillers; n=387) a. Their family life MAJOR harmful effect 67 MINOR harmful effect 15 NO harmful effect 14 Don t know/refused 4 6

7 (Asked of respondents who knew someone who has abused prescription painkillers; n=387) b. Their work life MAJOR harmful effect 58 MINOR harmful effect 15 NO harmful effect 23 Don t know/refused 4 (Asked of respondents who knew someone who has abused prescription painkillers; n=387) c. Their school life MAJOR harmful effect 37 MINOR harmful effect 6 NO harmful effect 46 Don t know/refused 11 (Asked of respondents who knew someone who has abused prescription painkillers; n=387) d. Their health MAJOR harmful effect 55 MINOR harmful effect 26 NO harmful effect 15 Don t know/refused 4 (Asked of respondents who knew someone who has abused prescription painkillers; n=387) Q13. Did it lead to their dying, or didn t this happen? Yes 21 No 77 Don t know/refused 2 7

8 IV. Regulation and Treatment Q14. The [name of state] state and federal governments currently regulate the prescribing and availability of strong prescription painkillers. Do you believe these regulations make it too easy or too hard for people to get strong prescription painkillers, or do you think they are about right? Too easy 29 Too hard 11 About right 51 Don t know/refused 9 Q15. There is a drug called Narcan or Naloxone that can prevent people from dying if they are experiencing an overdose of a prescription painkiller or heroin. Right now, adults in some states can buy this drug from pharmacists at many chain or retail pharmacies. Some other states restrict adults ability to buy this drug because they think it might encourage use of illegal drugs. Do you favor or oppose letting adults buy this drug from pharmacists at chain or retail pharmacies? Favor 42 Oppose 47 Don t know/refused 11 Q16. Many health insurance plans in [name of state] provide only limited coverage for drug treatment programs for people addicted to prescription painkillers or heroin. Some have suggested that the state government require private health insurers to provide more extensive coverage for these treatment programs. This might add to the cost of health insurance premiums for insured people. Do you favor or oppose the state government requiring private health insurers to provide more extensive coverage for these treatment programs? Favor 48 Oppose 46 Don t know 6 8

9 V. Causes of Rx Painkiller Abuse Q17. For each of the following, please tell me whether or not you think it is a major cause, a minor cause, or not a cause of abuse of strong prescription painkillers in [name of state]? How about (INSERT ITEM)? (IF NECESSARY: Is that a major cause, a minor cause, or not a cause of abuse of strong prescription painkillers in [name of state]) a. It is too easy to buy prescription painkillers illegally. MAJOR cause 55 MINOR cause 24 Not a cause 11 Don t know/refused 10 b. It is too easy to get prescription painkillers from people who have saved some from their old prescription. MAJOR cause 45 MINOR cause 35 Not a cause 13 Don t know/refused 7 c. Painkillers are prescribed too often, or in doses greater than what is needed MAJOR cause 45 MINOR cause 32 Not a cause 17 Don t know/refused 6 9

10 HSPH/Boston Globe Prescription Painkiller April 15 - April 19, 2015 Study #O1007 TABLE 005 I. Perceived Seriousness of the Problem and General Concern 1e. How about abuse of *** Strong prescription painkillers, such as Percocet, OxyContin or Vicodin?? *** Do you think that is an extremely serious problem in Massachusetts/(STATE), very serious, somewhat serious, not too serious, or not a problem at all? Base: Total Respondents Race/eth Gender Age Household Income Education ***************** Metro Status Region *********** ************************ ********************** ***************** White Black ***************** *********************** Fe- $25- $50- HS or Some Coll. Non- Non- Hisp- Sub- Nort North Total Male male <25K 49.9K 74.9K $75K+ Less Coll. Post Hisp Hisp anic Urban urban Rural East Cntrl South West ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== Total Unweighted Total Weighted (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P) (Q) (R) (S) (T) (U) (V) Extremely/Very Serious (Net) ============== D D Q Extremely serious D Very serious Somewhat/Not Too/Not At All (Net) ==================== EFG Somewhat serious B G L (sig=.05) (all_pairs) columns tested BC, DE, DF, DG, EF, EG, FG, HI, HJ, HK, IJ, IK, JK, LM, LN, MN, OP, OQ, PQ, RS, RT, ST, UV

11 HSPH/Boston Globe Prescription Painkiller April 15 - April 19, 2015 Study #O1007 TABLE 005 (continued) I. Perceived Seriousness of the Problem and General Concern 1e. How about abuse of *** Strong prescription painkillers, such as Percocet, OxyContin or Vicodin?? *** Do you think that is an extremely serious problem in Massachusetts/(STATE), very serious, somewhat serious, not too serious, or not a problem at all? Base: Total Respondents Race/eth Gender Age Household Income Education ***************** Metro Status Region *********** ************************ ********************** ***************** White Black ***************** *********************** Fe- $25- $50- HS or Some Coll. Non- Non- Hisp- Sub- Nort North Total Male male <25K 49.9K 74.9K $75K+ Less Coll. Post Hisp Hisp anic Urban urban Rural East Cntrl South West ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== Not too serious C Not a problem at all C N O O Don't know DEF O Refused * 1 * * 1 * 1 * 1 * 1 * * 1 1 * * * * (sig=.05) (all_pairs) columns tested BC, DE, DF, DG, EF, EG, FG, HI, HJ, HK, IJ, IK, JK, LM, LN, MN, OP, OQ, PQ, RS, RT, ST, UV Note: Percentage less than 0.5 printed as *.

12 HSPH/Boston Globe Prescription Painkiller April 15 - April 19, 2015 Study #O1007 TABLE 019 III. Rx Painkiller Abuse Problems Among People You Know 10. During the past 5 years, have you known anyone who has abused prescription painkillers, or not? Base: Total Respondents Race/eth Gender Age Household Income Education ***************** Metro Status Region *********** ************************ ********************** ***************** White Black ***************** *********************** Fe- $25- $50- HS or Some Coll. Non- Non- Hisp- Sub- Nort North Total Male male <25K 49.9K 74.9K $75K+ Less Coll. Post Hisp Hisp anic Urban urban Rural East Cntrl South West ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== Total Unweighted Total Weighted (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P) (Q) (R) (S) (T) (U) (V) Yes G G HI PQ R No DE K K O O T Don't know * * * * * * 1 * * * * * * * * * * 1 * * (sig=.05) (all_pairs) columns tested BC, DE, DF, DG, EF, EG, FG, HI, HJ, HK, IJ, IK, JK, LM, LN, MN, OP, OQ, PQ, RS, RT, ST, UV Note: Percentage less than 0.5 printed as *. PAGE 27

13 HSPH/Boston Globe Prescription Painkiller April 15 - April 19, 2015 Study #O1007 TABLE 034 IV. Regulation and Treatment 16. Many health insurance plans in Massachusetts/(STATE) provide only limited coverage for drug treatment programs for people addicted to prescription painkillers or heroin. Some have suggested that the state government require private health insurers to provide more extensive coverage for these treatment programs. This might add to the cost of health insurance premiums for insured people. Do you favor or oppose the state government requiring private health insurers to provide more extensive coverage for these treatment programs? Base: Total Respondents Impt Opioid Problem *********** Opioid Likely Get Some- Problem Addicted Know what/ *********** *********** Taken RX Someone Not Get- Very/ Govt Regs Make Party ID/Lean Painkiller Who Abused Ex- Too/ ting Very/ Some Leads Effective Getting Opioids ***************** 2 Years 5 Years treme Not Bet- Get- Some what To Heroin Treatment **************** Party ID Rep/ Dem/ Ind/ *********** *********** ly At ter ting what Un- *********** *********** Too About Too ***************** Lean Lean Don't Total Yes No Yes No Very All Same Worse Lkly lkly Yes No Yes No Easy Right Hard Rep Dem Ind Rep Dem Lean ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== Total Unweighted Total Weighted (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P) (Q) (R) (S) (T) (U) (V) (W) (X) Favor C E O P S S V V Oppose D N R TU WX Don't know D L (sig=.05) (all_pairs) columns tested BC, DE, FG, HI, JK, LM, NO, PQ, PR, QR, ST, SU, TU, VW, VX, WX Note: Percentage less than 0.5 printed as *. PAGE 58

14 HSPH/Boston Globe Prescription Painkiller April 15 - April 19, 2015 Study #O1007 TABLE 034 (continued) IV. Regulation and Treatment 16. Many health insurance plans in Massachusetts/(STATE) provide only limited coverage for drug treatment programs for people addicted to prescription painkillers or heroin. Some have suggested that the state government require private health insurers to provide more extensive coverage for these treatment programs. This might add to the cost of health insurance premiums for insured people. Do you favor or oppose the state government requiring private health insurers to provide more extensive coverage for these treatment programs? Base: Total Respondents Impt Opioid Problem *********** Opioid Likely Get Some- Problem Addicted Know what/ *********** *********** Taken RX Someone Not Get- Very/ Govt Regs Make Party ID/Lean Painkiller Who Abused Ex- Too/ ting Very/ Some Leads Effective Getting Opioids ***************** 2 Years 5 Years treme Not Bet- Get- Some what To Heroin Treatment **************** Party ID Rep/ Dem/ Ind/ *********** *********** ly At ter ting what Un- *********** *********** Too About Too ***************** Lean Lean Don't Total Yes No Yes No Very All Same Worse Lkly lkly Yes No Yes No Easy Right Hard Rep Dem Ind Rep Dem Lean ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== ===== Refused * * * * * * * * * * 1 * * * * 1 * * * (sig=.05) (all_pairs) columns tested BC, DE, FG, HI, JK, LM, NO, PQ, PR, QR, ST, SU, TU, VW, VX, WX Note: Percentage less than 0.5 printed as *.