Prescription opioid misuse and comorbid substance use: Past 30‐day prevalence, correlates and co‐occurring behavioral indicators in the 2016 National Survey on Drug Use and Health

Abstract

Background and objectives: Prescription opioid misuse has not been well examined in the context of comorbid substance use in representative samples of substance users. Past 30-day comorbid prescription opioid misuse and recreational substance use (e.g., alcohol, marijuana, cocaine, etc.) was studied in a representative sample of substance users in the United States using the 2016 National Survey on Drug Use and Health (NSDUH). Methods: Prevalence of prescription opioid misuse with and without comorbid substance use was estimated with the 2016 NSDUH. Generalized linear modeling was used to describe demographic correlates of opioid and comorbid substance use and explore the relation of opioid and comorbid substance use with social and behavioral health indicators. Results: The majority of past month prescription opioid misusers reported use of other substances including cigarettes, alcohol, marijuana, or hard drugs (cocaine, methamphetamine, etc.). Males and younger respondents had a significantly higher risk of reporting past month prescription opioid misuse with illicit drug or polydrug use (p's <0.01). Prescription opioid and polydrug users had the greatest odds of stealing property, selling drugs, having suicidal ideations, major depressive episode, and perceived treatment need in the past year compared to all other categories of prescription opioid misuse categories. Conclusions and scientific significance: Prescription opioid misuse is likely a part of a larger set of psychological, behavioral, and mental health problems. More attention should be given to the profiles of recreational (non-medical) substance use involving prescription opioids to curtail the current opioid crisis and prevent other similar epidemics in the future.

Biopsychosocial factors associated with opioid misuse in a 2017-2018 United States national survey: A comprehensive multivariate model

“…Examining opioid misuse using nationally representative data, Mojtabai, Amin-Esmaeili, Nejat, & Olfson 22 also found that prescribed-opioid misuse was associated with criminality, mental health distress, and other substance abuse or dependence. Similarly, Grigsby & Howard 23 and found that prescription opioid and polysubstance users had the greatest probability of past-year criminality and mental health distress.…”

A comprehensive multivariate model of biopsychosocial factors associated with opioid misuse and use disorder in a 2017-2018 United States national survey

“…Examining opioid misuse using nationally representative data, Mojtabai, Amin-Esmaeili, Nejat, and Olfson [49] also found that prescribed-opioid misuse was associated with criminality, mental health distress, and other substance abuse or dependence. Similarly, Grigsby and Howard [37] and found that prescription opioid and polysubstance users had the greatest probability of past-year criminality and mental health distress. Moreover, Prince [23] found that individuals with opioid misuse disorder who had a severe mental illness were at an increased risk of criminality and suicidality.…”

“…In the cases of marijuana dependence or abuse there is a positive relationship with opioid misuse. [37] A more recent review, however, found that medical marijuana use may decrease the probability of opioid use. [39] Campbell et al [39] further revealed that medical cannabis laws may slow the increase of opioid overdose deaths in states with medical cannabis laws compared to states with none.…”

“…The role of other substance dependence, abuse, and/or misuse, whether legal, illicit, or prescribed, has also been linked to opioid misuse and/or use disorder. Concurrent substance use such as nicotine and tobacco dependence [28,29], alcohol [30], sedatives [31], methamphetamines [32], tranquilizers [33][34][35], other analgesics [36], and marijuana [37] have been positively associated with opioid misuse and use disorder [37,38]. Marijuana may be context dependent as it has a mixed relationship with opioid use, misuse, and use disorder.…”

A comprehensive multivariate model of biopsychosocial factors associated with opioid misuse and use disorder in a 2017-2018 United States national survey

“…Concurrent substance use such as nicotine and tobacco dependence [25,26], alcohol [27], sedatives [28], methamphetamines [29], tranquilizers [30][31][32], other analgesics [33], and marijuana [34] have been positively associated with opioid misuse and use disorder [34,35]. Marijuana's association may be context dependent, as it has a mixed relationship with opioid use, misuse, and use disorder.…”