Background:
Despite the continuing epidemic of opioid misuse, data on the prevalence of prescription opioid use, misuse, and use disorders are limited.
Objective:
To estimate the prevalence of prescription opioid use, misuse, and use disorders and motivations for misuse among U.S. adults.
Design:
Survey.
Setting:
The 2015 National Survey on Drug Use and Health (NSDUH).
Participants:
72 600 eligible civilian, noninstitutionalized adults were selected for NSDUH, and 51 200 completed the survey interview.
Measurements:
Prescription opioid use, misuse, and use disorders.
Results:
Weighted NSDUH estimates suggested that, in 2015, 91.8 million (37.8%) U.S. civilian, noninstitutionalized adults used prescription opioids; 11.5 million (4.7%) misused them; and 1.9 million (0.8%) had a use disorder. Among adults with prescription opioid use, 12.5% reported misuse; of these, 16.7% reported a prescription opioid use disorder. The most commonly reported motivation for misuse was to relieve physical pain (63.4%). Misuse and use disorders were most commonly reported in adults who were uninsured, were unemployed, had low income, or had behavioral health problems. Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids for free from friends or relatives for their most recent episode of misuse.
Limitation:
Cross-sectional, self-reported data.
Conclusion:
More than one third of U.S. civilian, noninstitutionalized adults reported prescription opioid use in 2015, with substantial numbers reporting misuse and use disorders. Relief from physical pain was the most commonly reported motivation for misuse. Economic disadvantage and behavioral health problems may be associated with prescription opioid misuse. The results suggest a need to improve access to evidence-based pain management and to decrease excessive prescribing that may leave unused opioids available for potential misuse.
Primary Funding Source:
U.S. Department of Health and Human Services.
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Author, Article and Disclosure Information
From Substance Abuse and Mental Health Services Administration, Rockville, Maryland; National Institute on Drug Abuse, Bethesda, Maryland; and Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC.
Note: Dr. Han had full access to all of the data in this study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Disclaimer: The findings and conclusions of this study are those of the authors and do not necessarily reflect the views of the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse of the National Institutes of Health, and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services.
Financial Support: The NSDUH was supported by contracts from the Substance Abuse and Mental Health Services Administration. This study was jointly sponsored by the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse of the National Institutes of Health, and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services.
Disclosures: Dr. Compton reports stock holdings in Pfizer, General Electric, and 3M Company. Dr. Blanco reports stock holdings in Eli Lilly, Sanofi, and General Electric. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0865.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol and statistical code: Available from Dr. Han (e-mail, Beth.
Corresponding Author: Wilson Compton, MD, MPE, National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, MSC 9589, Bethesda, MD 20892-9589; e-mail, [email protected]
Current Author Addresses: Dr. Han: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, 15E85C, Rockville, MD 20857.
Drs. Compton and Blanco: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, MSC 9589, Bethesda, MD 20892-9589.
Dr. Crane: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, 15E89D, Rockville, MD 20857.
Dr. Lee: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Room 5219, Bethesda, MD 20892.
Dr. Jones: Office of Science and Data Policy, Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 200 Independence Avenue SW, 434E.2, Washington, DC 20201.
Author Contributions: Conception and design: B. Han, W.M. Compton, C. Blanco, C.M. Jones.
Analysis and interpretation of the data: B. Han, W.M. Compton, C. Blanco, J. Lee, C.M. Jones.
Drafting of the article: B. Han, W.M. Compton, C. Blanco, J. Lee, C.M. Jones.
Critical revision of the article for important intellectual content: B. Han, W.M. Compton, C. Blanco, E. Crane, J. Lee, C.M. Jones.
Final approval of the article: B. Han, W.M. Compton, C. Blanco, E. Crane, J. Lee, C.M. Jones.
Provision of study materials or patients: B. Han.
Statistical expertise: B. Han, C. Blanco.
Administrative, technical, or logistic support: B. Han, W.M. Compton.
Collection and assembly of data: B. Han.
This article was published at Annals.org on 1 August 2017.
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