US Adults With Mental Health Disorders Receive More Prescription Opioids

Given the current US opioid epidemic, identification of specific populations that receive prescription opioids is of strategic importance for risk-mitigation efforts. Using self-report and administrative or pharmacy database linkages from the Medical Expenditure Panel Survey (a nationally representative sample of non-institutionalized US adults), this cross-sectional study sought to derive national estimates of prescription opioid receipt among people with mental health (mood or anxiety) disorders and examine factors associated with their use.

  • Of the almost 52,000 survey participants, 14% had a mental health disorder.
  • Prescription opioid receipt (defined as >2 filled opioid prescriptions in a calendar year) was more prevalent among adults with a mental health disorder compared with those without (19% versus 5%, respectively).
  • Even after adjusting for socio-demographics, health status, and use of selected health services, adults with a mental health disorder were more than twice as likely as those without to receive prescription opioids (odds ratio, 2.08).
  • Based on these findings, national estimates approximate that of the 38.6 million US adults with a mental health disorder, 7.2 million receive prescription opioids.
  • Furthermore, 51% of all opioid prescriptions distributed in the US are provided to adults with a mental health condition (60 million of 115 million prescriptions).

Comments: Mental health disorders are a risk factor for non-medical use of prescription opioids. The higher prevalence of prescription opioid receipt among adults with a mental health disorder suggests that this population is critical to consider when addressing the issue of opioid use from a health system or policy perspective. Future studies should focus on identifying patient and provider factors related to higher opioid prescribing rates among this group and developing interventions to mitigate risk.

Seonaid Nolan, MD

Reference: Davis MA, Lin LA, Liu H, Sites BD. Prescription opioid use among adults with mental health disorders. J Am Board Fam Med. 2017;30(4):507–517.

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