Sources of Misused Prescription Opioids and Their Association with Prescription Opioid Use Disorder in the United States: Sex and Age Differences

Subst Use Misuse. 2020;55(6):928-936. doi: 10.1080/10826084.2020.1713818. Epub 2020 Jan 24.


Background: Prescription opioid (PO) misuse and prescription opioid use disorder (POUD) are a national crisis in the USA. To inform strategies for reducing the PO epidemic, research is needed on the sources of misused POs and their association with POUD. Methods: Past-year PO misusers aged ≥12 (N = 6033) from the 2015 to 2016 National Surveys on Drug Use and Health were analyzed. The most recent source of misused POs was assessed. Logistic regression analyses were used to determine the association between the sources of misused POs and past-year POUD. All analyses were stratified by age groups for each sex. Results: Overall, the most common sources of misused POs were obtaining from friends/relatives for free (40.27%) and physicians (36.59%). Males had a higher prevalence of buying POs from friends/relatives or drug dealers/strangers than females. Significant age differences also emerged. Buying POs from drug dealers/strangers (vs. obtaining POs free from friends/relatives) was strong predictor of past-year POUD in both sexes. In the sex- and age-stratified analyses, significant associations of past-year POUD with (1) buying from drug dealers/strangers emerged among males aged 18+ and females aged 26+; (2) buying from friends/relatives emerged among males aged 12+ and females aged 18-25; (3) obtaining from physicians emerged among males aged 18+ and females aged 26+. Conclusions: Our findings indicate different risk profiles for POUD across sex and age groups with different diversion sources. Prevention and treatment programs for POUD should be tailored to consider sex and developmental age differences in sources of opioids.

Keywords: Diversion; age differences; prescription opioid misuse; prescription opioid use disorder; sex differences.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / therapeutic use
  • Female
  • Friends
  • Humans
  • Male
  • Opioid-Related Disorders* / drug therapy
  • Opioid-Related Disorders* / epidemiology
  • Prescription Drug Misuse*
  • Prescriptions
  • Prevalence
  • United States / epidemiology
  • Young Adult


  • Analgesics, Opioid