Non-medical Use, Abuse and Dependence on Prescription Opioids Among U.S. Adults: Psychiatric, Medical and Substance Use Correlates

Drug Alcohol Depend. 2008 Apr 1;94(1-3):38-47. doi: 10.1016/j.drugalcdep.2007.09.018. Epub 2007 Dec 11.

Abstract

Background: Non-medical use of prescription opioids carries risks including development of abuse/dependence. Such use may correlate with psychiatric, medical, and substance use characteristics.

Methods: Cross-sectional survey, the 2002-2004 National Survey on Drug Use and Health. Respondents 18 years and older (n=91,823). Bivariate and multivariable associations were investigated.

Results: The prevalence of past-year non-medical use of prescription opioids was 4.5%. Of those with non-medical use, 12.9% met criteria for abuse/dependence. On multivariable analysis, past-year non-medical use was associated with panic (AOR 1.2; 95% CI 1.04-1.5), depressive (AOR 1.2; 95% CI 1.01-1.5) and social phobic/agoraphobic symptoms (AOR 1.2; 95% CI 1.1-1.4). Among those with past-year non-medical prescription opioid use, those with abuse/dependence were more likely to have panic (AOR 1.7; 95% CI 1.2-2.4) and social phobic/agoraphobic symptoms (AOR 1.7; 95% CI 1.2-2.4). In addition, they were more likely to report fair/poor health (AOR 2.1; 95% CI 1.4-3.0), have misused another class of prescription medication (AOR 1.7; 95% CI 1.2-2.3), have used heroin (AOR 2.9; 95% CI 1.2-6.9) and initiated substance use before the age of 13 (AOR 4.7; 95% CI 1.1-19.9).

Conclusions: Non-medical use of prescription opioids is common. Furthermore, nearly 13% of those with non-medical use meet criteria for abuse/dependence. Panic, social phobia and agoraphobia, low self-rated health status, and other substance misuse among those with non-medical use of prescription opioids should alert clinicians to screen for abuse and dependence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Agoraphobia / diagnosis
  • Agoraphobia / epidemiology
  • Agoraphobia / psychology
  • Alcohol Drinking / epidemiology
  • Child
  • Chronic Disease
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Prescriptions / statistics & numerical data*
  • Factor Analysis, Statistical
  • Female
  • Health Status
  • Humans
  • Male
  • Opioid-Related Disorders / epidemiology*
  • Pain / drug therapy*
  • Pain / epidemiology*
  • Panic Disorder / diagnosis
  • Panic Disorder / epidemiology
  • Panic Disorder / psychology
  • Phobic Disorders / diagnosis
  • Phobic Disorders / epidemiology
  • Phobic Disorders / psychology
  • Prevalence
  • Surveys and Questionnaires
  • United States / epidemiology