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To evaluate medical and pharmacy costs associated with breakthrough pain (BTP) in a commercially-insured population with chronic, cancer-related pain. METHODS: The National Breakthrough Pain Survey studied a large commercially-insured population using claims data and structured interviews to assess the prevalence, characteristics, and impact of BTP. Adult patients with ≥2 medical claims at an interval ≥3 months with an ICD-9-CM code indicating a chronic pain condition (cancer or noncancer) and ≥3 opioid prescription claims consistent with chronic use were eligible. Patients were called and interviewed after providing consent; those verifying cancer pain were included in this sub-analysis. All-cause medical and pharmacy costs in 2010 US dollars were determined from administrative claims data for the 12-month period before the survey date. Generalized linear models with gamma distribution were constructed because of the skewed nature of the cost data. RESULTS: A total of 2198 patients were interviewed, 1279 had controlled persistent pain, and 145 of the latter group had cancer pain. Of those with cancer pain, BTP was reported by 77.2% (BTP, 112; no BTP, 33

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"One purpose of this paper is to define, as precisely as possible, patterns of drug use in one subculture of the youthful population. Another of its purposes is to emphasize the distinction between "drug use" and "drug abuse." Among the patients in our clinic the taking of drugs is al most universal; abuse, on the other hand, is of a much lower order of magnitude. Admittedly, imprecisely defined criteria separate these practices. Furthermore, separation of drug use from drug abuse does not imply acceptance of the one and rejection of the other."