Prescription Opioid Use Disorder Among Adults Reporting Prescription Opioid Use With or Without Misuse in the United States
Abstract
Objective: We examined prescription-related opioid use disorder (POUD) prevalence, individual symptoms, severity, characteristics, and treatment by prescription opioid misuse status among adults with prescription opioid use. Methods: Cross-sectional study using nationally representative data from 47,291 adults aged ≥18 years who participated in the 2021 National Survey on Drug Use and Health. Past-year POUD used DSM-5 criteria. Results: Among US adults with past-year prescription opioid use, 12.1% (95% CI, 11.1%–13.1%) misused prescription opioids, and 7.0% (95% CI, 6.2%–8.9%) had POUD. Among adults with POUD, 62.0% (95% CI, 56.7%–67.2%) reported no prescription opioid misuse, including 49.1% (95% CI, 43.5%–54.7%) with mild POUD, 11.0% (95% CI, 6.5%–15.4%) with moderate POUD, and 1.9% (95% CI, 0.6%–3.2%) with severe POUD. Prevalence of POUD was 4.5 times higher (prevalence ratio = 4.5, 95% CI, 3.6–5.6) among those reporting prescription opioid misuse (22.0%, 95% CI, 18.6%–25.8%) than those reporting use without misuse (4.9%, 95% CI, 4.2%–5.7%). Among adults reporting prescription opioid use without misuse, high POUD prevalence was found for those with ≥3 emergency department visits (16.4%, 95% CI, 11.5%–23.0%), heroin use/use disorder (17.1%, 95% CI, 5.2%–43.8%), prescription sedative/tranquilizer use disorder (36.2%, 95% CI, 23.6%–51.1%), and prescription stimulant use disorder (21.8%, 95% CI, 11.0%–38.7%). Conclusions: Moderate-to-severe POUD is more frequent among adults…
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