Prescription Pain Reliever Misuse Prevalence, Correlates, and Origin of Possession throughout the Life Course

Background and Purpose: Current prevalence of prescription pain reliever misuse (4.6 million Americans) is of considerable concern. Accidental overdose and increased risk for illicit drug and alcohol use are associated with pain reliever misuse (McCabe, Cranford, & West, 2008). While many adolescents and young adults report the sources of prescription drug misuse as family and friends (McCabe, West, & Boyd, 2013), little is known about how older adults come to possess, and subsequently misuse, pain relievers. The belief that risks for pain reliever misuse are different among age groups is consistent with a life-course perspective, which suggests that experiences across one’s lifespan are subject to change by immediate conditions, future options, and short-term events (Hser, Hamilton, & Niv, 2009). Thus, the aim of this study was to examine pain reliever misuse among specific age groups in an effort to understand whether correlates of pain reliever misuse are stable with age. We also sought to examine whether age differences exist in the sources of pain reliever misuse.

Methods: Data is from the combined 2011 and 2012 National Survey of Drug use and Health (NSDUH), an annual nationally representative survey administered by SAMHSA. The total sample from the 2011 and 2012 NSDUH was 113,665. Participants were assessed for past-year prescription pain reliever misuse, social demographics and clinical variables. Among participants who reported past-year pain reliever misuse, participants were asked how they came to possess pain relievers. Multivariate logistic regression analyses examined sociodemographic and clinical correlates of prescription pain reliever misuse, stratified by age groups (12 to 17 years, 18 to 25 years, 26 to 34 years, 35 to 49 years, and 50 years or older). Bivariate analyses examined sources of pain reliever possession by age. All analyses used population weights provided within the NSDUH to adjust for nonresponse and geographic distribution of the sample

Results: Among respondents, 4.7% reported past-year prescription pain reliever misuse. Prevalence differed significantly among age groups (12 to 17: 5.9%, 18 to 25: 10.2%, 26-34: 7.7%, 35 to 49: 4.3%, and individuals aged 50 or older: 1.7%). While many social and clinical correlates of pain reliever misuse emerged among younger respondents, these correlates diminished in significance among older adults. Only past-year illicit drug use disorders were a significant predictor of pain reliever misuse across all age groups. Finally, older adults were more likely to report pain reliever possession from multiple medical doctors, whereas younger individuals were more likely to possess pain reliever from friends/relatives or through purchase from a drug dealer/stranger.

Conclusions and Implications: As new approaches to treating prescription drug use are considered, attention must be paid to the polysubstance nature of many prescription drug abusers, especially among individuals engaged in prescription pain reliever misuse. Furthermore, increased efforts to better screen for illicit drug use and greater efforts to coordinate patient prescription records among medical care providers may be high priorities in developing interventions to reduce rates of misuse of prescription pain relievers, especially among older adults.