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Evaluating non-medical prescription opioid demand using commodity purchase tasks: test-retest reliability and incremental validity

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Abstract

Rationale

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.

Objectives

Utilize a purchase task procedure to measure the incremental validity and test-retest reliability of opioid demand.

Methods

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.

Results

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).

Conclusions

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.

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Funding

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.

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Authors and Affiliations

  1. Department of Psychology, University of Kentucky College of Arts and Sciences, 171 Funkhouser Drive, Lexington, KY, 40506-0044, USA

    Justin C. Strickland, Joshua A. Lile & William W. Stoops

  2. Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY, 40536, USA

    Joshua A. Lile & William W. Stoops

  3. Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY, 40509, USA

    Joshua A. Lile & William W. Stoops

  4. Center on Drug and Alcohol Research, University of Kentucky College of Medicine, 845 Angliana Ave, Lexington, KY, 40508, USA

    William W. Stoops

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  1. Justin C. Strickland
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Correspondence to Justin C. Strickland.

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Strickland, J.C., Lile, J.A. & Stoops, W.W. Evaluating non-medical prescription opioid demand using commodity purchase tasks: test-retest reliability and incremental validity. Psychopharmacology 236, 2641–2652 (2019). https://doi.org/10.1007/s00213-019-05234-y

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