Living in a Household With Someone Receiving Prescription Opioids Is Associated With Initiation of Prescription Opioid Use

Opioid prescribing has increased dramatically in the US over the past few decades and has paralleled an increase in prescription opioid use disorders and overdose. Prescription opioid use may spread through families and other networks. Researchers used a commercial insurance database to investigate the association between being prescribed an opioid for the first time and being in a household with someone who is prescribed opioids. Households with individuals prescribed non-steroidal anti-inflammatory (NSAID) medications were used as a comparison.

• The study included 12.7 million individuals in 5.9 million “opioid households” and 6.4 million in 3 million “NSAID households.”
• The unadjusted 1-year risk of being prescribed an opioid for the first time was 11.68% in an opioid household and 10.60% in an NSAID household. The adjusted risk was 11.83% for opioid households and 11.11% for NSAID households, an absolute difference of 0.71%.

Comments: This study suggests that the likelihood of being prescribed an opioid for the first time increases with household exposure. While the absolute increase seems modest (1 in 140), when applied to millions of households, this translates to tens of thousands of people. Moreover, this analysis only captures those who initiated opioid use through prescription; there are many more who are taking household members’ opioids without a prescription.

Darius A. Rastegar, MD

Reference: Seamans MJ, Carey TS, Westreich DJ, et al. Association of household opioid availability and prescription opioid initiation among household members. JAMA Intern Med. 2018;178:102–109.