Patient misuse of prescribed opioids was found to be associated with opioid use disorder, misuse of other drugs, history of illegal activity, and psychological distress, according to a study published in Pharmacoepidemiology and Drug Safety.

These results provide more supporting evidence for improved monitoring of opioid prescriptions in clinical practices.

The study examined the data of patients from the National Survey on Drug Use and Health for 2015 and 2016 who reported using opioids in the past year (n=31,068). The prevalence and correlates of self-reported misuse of prescribed opioids (ie, use of a larger dose, more frequent use, or use for a longer period than prescribed) were assessed. Multivariable logistic-regression models and the machine-learning method of boosted regression were conducted to identify the correlates of misuse.

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Using weighted National Survey on Drug Use and Health estimates, over 89 million adults in the United States were found to use prescription opioids each year, 3.9 million of whom (4.4%) reported misuse. The results indicated that prescribed opioid misuse was most significantly associated with co-occurring misuse of opioids without a prescription, misuse of benzodiazepines, presence of other drug used disorders, and psychological distress.

In terms of demographics, prescription opioid misuse was found to be more common in men compared with women; in younger and middle‐aged adults compared with those ages ≥65; in individuals who were separated, divorced, or never married compared with those who were currently married; in individuals who did not graduate high school compared with college graduates; in individuals who were unemployed vs employed; in individuals with lower income vs income >200% of the federal poverty level; and in individuals who engaged in illegal activities in the past year or reported a history of arrest, parole, or probation compared with those who did not.

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Misuse of prescribed opioids was found to be strongly associated with prescription opioid use disorder. This association was particularly strong in participants who misused more potent opioids or started misusing opioids before the current year.

“Given the associated adverse health outcomes, this extent of prescription opioid misuse is a major public health care concern,” noted the study authors.

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Mojtabai R, Amin-Esmaeili M, Nejat E, Olfson M. Misuse of prescribed opioids in the United States [published online February 5, 2019]. Pharmacoepidemiol Drug Saf. doi:10.1002/pds.4743