The State of Medical and Non-Medical Use of Prescription Opioids in the US

The National Survey on Drug Use and Health is conducted annually among US adolescents and adults and includes questions about prescription opioid use and non-medical use of prescription opioids (NMUPO). Researchers used data from interviews of 51,200 adults aged ≥18 in 2015 to investigate the prevalence of prescription opioid use and NMUPO, and associated demographic factors and motivations.

  • Overall, 38% of respondents (representing an estimated 92 million US adults) reported taking an opioid in the past year; 4.7% reported NMUPO (12 million); 0.8% met criteria for an opioid use disorder (2 million).
  • Among those who reported NMUPO, 60% reported taking an opioid without a prescription, 22% used them in greater amounts than directed, 15% more often than directed, and 13% longer than directed.
  • Among those who reported NMUPO, the most common motivation was relief of physical pain (66%), followed by relaxing (11%), and getting high (11%). Among those with opioid use disorder, the most commonly reported motivations were relief of physical pain (49%), getting high (16%), being “hooked” (12%), and to relax (9%).

Comments: This survey shows that prescription opioid use and NMUPO are common in the US. The fact that relief of physical pain is the most frequently reported motivating factor for NMUPO is of interest and should be investigated further. The authors argue that this demonstrates the need for “evidence-based pain management,” but it is far from clear that this will help. There is very little evidence to guide us and, so far, the notion that pain is something that must be “managed” aggressively has only contributed to this problem.

Darius A. Rastegar, MD

Reference: Han B, Compton WM, Blanco C, et al. Prescription opioid use, misuse, and use disorders in US adults: 2015 National Survey on Drug Use and Health. Ann Intern Med. 2017;167(5):293–301.

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