MedicalResearch.com Interview with:
Beth Han, MD, PhD, MPH
From Substance Abuse and Mental Health Services Administration, Rockville, Maryland
National Institute on Drug Abuse, Bethesda, Maryland and
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Using the 2015 National Survey on Drug Use and Health (NSDUH), this is the first study examining the prevalence of overall prescription opioid use in addition to misuse, use disorders, and motivations for misuse in the U.S. adult population. The 2015 NSDUH collected nationally representative data on prescription opioid use, misuse, use disorder, and motivations for misuse among the U.S. civilian, noninstitutionalized population aged 12 or older. In 2015, NSDUH started to collect data on overall prescription opioid use as well as data on motivations for prescription opioid misuse.
This study found that in 2015, 91.8 million (37.8%) U.S. civilian, non-institutionalized adults used prescription opioids, 11.5 million (4.7%) misused them, and 1.9 million (0.8%) had a prescription opioid use disorder. Among adults who used prescription opioids, 12.5% reported misuse and, of those reporting misuse, 16.7% reported a prescription opioid use disorder.
The most common reported misuse motivation was to relieve physical pain (63.4%). Misuse and use disorders were most commonly reported in adults who were uninsured, were unemployed, had low income, or had behavioral health problems. Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids free from friends or relatives for their most recent misuse.
MedicalResearch.com: What should readers take away from your report?
Response: First, our study shows high prevalence of pain in the U.S. Physical pain is a common reason for use even among adults with prescription opioid misuse and use disorders.
Second, our study suggests that pain is a poorly addressed clinical and public health problem in the U.S. and that pain may be a key part of the pathway to misuse or addiction.
Third, our findings highlight the importance of interventions targeting medication sharing, selling, and diversion and underscore the need to follow prescribing guidelines to minimize environmental availability of opioids due to excessively large numbers of leftover medications.
Fourth, persons identified with prescription opioid misuse and use disorder should be queried about multiple co-occurring behavioral health conditions and, if present, should be referred for treatment.
Finally, uninsured adults, unemployed adults, and low-income adults have a higher prevalence of prescription opioids misuse and prescription opioid use disorders. A major take away is that actions should be taken to expand safe, evidence-based pain treatment and decrease excessive prescribing that may leave unused opioids available for potential misuse.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our findings underscore the urgent need of future research for more effective approaches to pain treatment, including increased access to high-quality, evidence-based care, development of high-potency non-addictive analgesics, and multimodal treatment of pain.
MedicalResearch.com: Is there anything else you would like to add?
Response: SAMHSA leads public health efforts to improve our nation’s behavioral health. Our mission is to reduce the impact of substance abuse and mental illness on America’s communities. Actions should be taken to expand safe, evidence-based pain treatment and decrease excessive prescribing that may leave unused opioids available for potential misuse.
To learn more about the National Survey on Drug Use and Health and related SAMHSA reports, please visit: https://www.samhsa.gov/data/
To learn more about mental and substance use disorders, please visit: https://www.samhsa.gov/disorders
To learn more about behavioral health treatments and services, please visit: https://www.samhsa.gov/treatment
And to find alcohol, drug, or mental health treatment programs, please visit: https://findtreatment.samhsa.gov/
The findings and conclusions of this study are those of the authors and do not necessarily reflect the views of the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse of the National Institutes of Health, and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services. Dr. Han reports no conflicts of interest.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Ann Intern Med. 2017 Aug 1. doi: 10.7326/M17-0865. [Epub ahead of print]
Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health.
Han B1, Compton WM1, Blanco C1, Crane E1, Lee J1, Jones CM
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.