Heavy Episodic Drinking Among US Adults and Adolescents Nearly Doubles the Risk for Non-medical Use of Prescription Opioids

In 2016, 17,000 US deaths were the result of prescription opioid use. Furthermore, one in five of these deaths also involved the use of alcohol. While concurrent alcohol and opioid use has previously been shown to be a risk factor for overdose, the purpose of this study was: 1) to assess the association between past 30-day drinking patterns* and non-medical use of prescription opioids (NMUPO) among US adults and adolescents; and 2) examine the relationship between heavy episodic drinking frequency and NMUPO. Data were derived from 160,812 respondents who completed the US National Survey on Drug Use and Health between 2012 and 2014.

  • 6% of US adults and adolescents—a weighted estimate of 4.2 million people—reported past 30-day NMUPO between 2012 and 2014, with more than half (2.2 million) also reporting heavy episodic drinking.
  • Heavy episodic drinking was associated with a 1.7 times increased risk of reporting NMUPO compared with the non-drinking group, while current/non-heavy episodic drinking was not associated with NMUPO.
  • Overall, the prevalence of NMUPO increased significantly with the frequency of heavy episodic drinking.

* Defined as: Non-drinking: not having consumed any alcohol on any day in the past 30 days; Current/non-heavy episodic drinking: consuming ≥1 drink on ≥1 days in the past 30 days (but not meeting criteria for heavy episodic drinking); Heavy episodic drinking: having consumed ≥5 drinks (for males) or ≥4 drinks (for females) on ≥1 occasion in the past 30 days.

Comments: In this study, the prevalence of NMUPO increased significantly with the frequency of heavy episodic drinking. Accordingly, strategies focused on preventing heavy episodic drinking may also serve to reduce NMUPO and overdoses involving alcohol.

Seonaid Nolan, MD

Reference: Esser MB, Guy GP Jr, Zhang K, Brewer RD. Binge drinking and prescription opioid misuse in the US, 2012–2014. Am J Prev Med. 2019;57(2):197–208.

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