US Pharm. 2017;42(3):6.

According to the 2015 National Survey on Drug Use and Health (NSDUH), prescription pain relievers (PPRs)—including opioids—were used by 36.4% (97.5 million) persons aged 12 years and older. Nearly 63% of adults used PPRs without a prescription, at a higher dosage than prescribed, or more often than prescribed in order to relieve physical pain. Other reasons for misuse were feeling good/getting high (12.1%), relieving tension/relaxing (10.8%), aiding sleep (4.4%), managing feelings/emotions (3.3%), experiencing what the drug is like (2.5%), being hooked/needing the drug (2.3%), and decreasing or increasing effects of other drugs (0.9%).

Characteristics of PPR Users: Of 97.5 million past-year users of PPRs, 5.7 million (22.7%) were aged 12 to 17 years, 12.1 million (34.8%) were aged 18 to 25 years, and 79.7 million (38.3%) were aged 26 years and older. Females outnumbered males in PPR use (38.8% vs. 33.9%, respectively). Use of PPRs was more prevalent in small metropolitan areas (38.6%) versus nonmetropolitan (38.5%) and large metropolitan (34.7%) areas. Regionally, the difference in PPR use (11%) between the South (37.8%) and the Northeast (33.6%) was greater than the difference (2.5%) between the West (36.8%) and the Midwest (35.9%).

Characteristics of PPR Misusers: About 5% of adults (12.5 million) misused PPRs. Misuse was more prevalent in persons aged 18 to 25 years (8.5%) than in those aged 26 years and older (4.1%) and those aged 12 to 17 years (3.9%). Males misused PPRs more often than females did (5.3% vs. 4.0%). Most PPR misuse occurred in the West (5.3%), and the least occurred in the Northeast (4.2%); the size of metropolitan area had no impact on incidence. Among adults with any mental illness, 4.8 million (11.1%) misused PPRs.

Types of PPRs Used and Misused: The PPR most frequently used (21.8% of adults; 58.3 million people) and misused (2.7% of adults; 7.2 million) was hydrocodone, followed by the use (10.4% of adults; 27.9 million) and misuse (1.6% of adults; 4.3 million) of oxycodone products. Morphine was the PPR fourth most commonly used (2.7% of adults; 7.2 million) and misused (0.3% of adults; 0.7 million). OxyContin was used by 9.1 million adults (3.4%) and misused by 1.7 million (0.7%). Narcotic analgesic PPRs used to reduce or quit heroin or other opiate use were buprenorphine (0.9%; 2.4 million) and methadone (0.6%; 1.6 million), which were misused by 0.3% (0.7 million) and 0.2% of adults (0.5 million), respectively. The FDA estimates that more than 33 million adults have misused long-acting and extended-released opioids. People who used substances other than prescription drugs (e.g., methamphetamines, cocaine, inhalants, marijuana, cigarettes, alcohol) were more likely to misuse PPRs.

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