Nonmedical Opioid Use Has Doubled Over a Decade

The percentage of Americans who have used opioids for nonmedical reasons has more than doubled over the course of a decade.

A recent study from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that, in a 12-month period, 4.1% of Americans used drugs like OxyContin and Vicodin either without a prescription or inappropriately between 2012 and 2013. By comparison, between 2001 and 2002, this percentage was 1.8%.

The data came from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and was published in theJournal of Clinical Psychiatry.

The researchers looked at a year’s worth of prevalence, correlates, psychiatric comorbidity, and treatment of nonmedical prescription opioid use (NMPOU) and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders’ definition of NMPOU disorder (NMPOUD).

One notable finding was that the prevalence of NMPOU over an individual’s lifetime was 11.3% around 2012-2013, while it was considerably lower at 4.7% in 2001-2002.

The prevalence of NMPOUD was 0.9% in the past 12 months and 2.1% in an individual’s lifetime. Back in 2001-2002, the prevalence was 0.4% and 1.4%, respectively.

The researchers discovered a few trends in the data. For example, opioid use was more popular among men, but there were no differences in the recognized disorder between the sexes.

The patient populations most likely to use opioids for nonmedical reasons were individuals aged 18 to 64 years, white individuals, Native Americans, individuals who made less than $70,000 per year, and individuals with a high school-level of education or less.

The researchers also found a link between lifetime or 12-month use of opioids with other drug use disorders; post-traumatic stress disorder; borderline, schizotypal, and antisocial personality disorders; persistent depression; major depressive disorder (for NMPOU); and bipolar disorder (for NMPOUD).

“The increasing misuse of prescription opioid pain relievers poses a myriad of serious public health consequences,” sais Nora D. Volkow, MD, director of the National Institute on Drug Abuse, in a press release. “These include increases in opioid use disorders and related fatalities from overdoses, as well as the rising incidence of newborns who experience neonatal abstinence syndrome. In some instances, prescription opioid misuse can progress to intravenous heroin use with consequent increases in risk for HIV, hepatitis C, and other infections among individuals sharing needles.”

The researchers found that only 5% of those who misused opioids received treatment, while 17% of those with NMPOUD received help.

“NMPOU and NMPOUD have considerably increased over the past decade, are associated with a broad array of risk factors and comorbidities, and largely go untreated in the United States,” the researchers concluded.

The study authors called for more research into the characteristics and outcomes of NMPOU and NMPOUD, and they suggested that further information could be used for evidence-based interventions and prevention.

One way clinicians can help is by informing patients that combining opioids with sedative drugs is extremely dangerous.

“Given the dramatic increase in nonmedical use of prescription opioids, it is important that clinicians and patients also recognize the potent interaction of opioids with alcohol and other sedative-hypnotic drugs—an interaction that can be lethal,” said NIAAA Director George F. Koob, PhD, in a press release.