Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates

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.