Health and Behavioral Characteristics of US Adults 50 and Older Who Misuse Prescription Opioids

Purpose: It is estimated that 40% of adults age 50 and older use prescription opioids. Importantly, 6% in this age group misuse prescription opioids. Opioid misuse is defined as not taking prescription opioids as recommended by the care providers, which includes, but is not limited to, taking more prescription opioids than recommended, taking it for reasons other than pain management, or taking it without prescription. Compared to other adult age groups, this age group tends to have more and/or serious health issues and chronic painful conditions that may lead to misuse of prescription opioids. A number of variables may be related to those who misuse opioids, including demographic factors, health issues, motivations, and the source from which the opioid is obtained. To address this issue, more information is needed. Therefore, the objective of this study is to report the characteristics of those who misuse, motivations for misuse and sources of misused prescription opioids in the past 12 months in this age group.

Methods: This study analyzed data obtained from 2015 National Survey on Drug Use and Health (NSDUH) to achieve the objective. There were 72,600 eligible civilian, noninstitutionalized adults selected for NSDUH, and 51,200 completed the survey. Only adults age 50 and older were included in the analysis.

Results: Major findings include: (1) Respondents who reported misuse tended to be male, Hispanic, divorced/separated/never been married, and unemployed. They also had less than a high school education, no health insurance, and an annual family income of less than $20,000. (2) Respondents who rated themselves as having fair/poor health tended to report more misuse of prescription opioids compared to those who rated themselves as having excellent health (p=.001). (3) Respondents who reported having a major depressive episode in the past year were more likely to misuse prescription opioids than those who did not have this health issue (p=.000). (4) Distress scores were significantly higher in respondents who misused prescription opioids than those without misuse (p=.000). (5) Increased impairment scores were more likely to occur in those who misused prescription opioids than those who did not (p=.000). (6) Among respondents who misused prescription opioids, the majority used the prescription opioids for relief of physical pain (73%), followed by relaxation or tension relief (9%), for feeling good/getting high (5%), for helping with sleep (5%), and others. (7) Sources of misused prescription opioids were mainly from one doctor (49%) or from friends and relatives for free (31%). Approximately 5% bought the prescription opioids from friends and relatives and 4% shopped for prescription opioids from more than one doctor.

Conclusion: Compared to the US population, this age group displayed a similar, yet unique, pattern of opioid misuse. Understanding the characteristics for those misuse prescription opioids as well as motivations and sources for misuse will help develop tailored behavioral interventions to treat prescription opioids misuse in this growing age population.