Correlates of Opioid Pain Reliever Misuse Among Young Adults

Background:  From 2002 to 2015, opioid analgesic (pain reliever) related deaths increased 2.8-fold (NIH, 2017). Rates of opioid analgesic misuse are highest among young adults aged 18 to 25, with 7.1 percent reporting nonmedical use in the past year (NSDUH, 2016). For many adults that develop an opioid use disorder, initiation frequently begins in young adulthood (Hadley et al., 2017).  However, only a small number of studies have examined the specific correlates of opioid pain reliever use in young adults (Tapscott & Schepis, 2013).  The present study examines factors associated with opioid pain reliever misuse among young adults in Michigan.

 

Methods: Young adults ages 18-25 (N=4,257) were recruited through paid Facebook advertising to complete an online survey. Participants were asked about their past year misuse of four types of prescription medications (opioid pain relievers, sedatives, stimulants, and sleep medications).  Specifically, they indicated whether they had used a prescription medication that did not belong to them in the past year, or if they took a medication in larger quantities or more often than was prescribed. Measures also included demographics, other substance use (binge drinking, marijuana use) and perceived risk of opioid analgesic use. The sample was 73.1% female and 39.4% were not enrolled in school/university. While most respondents were white (75.8%), the sample also included African-American, Asian, Latinx, and Arabic/Middle Eastern youth. 

Logistic regression analyses were used to test associations between past year prescription pain reliever misuse, demographic characteristics (e.g. age, race, gender) and other substance use variables (e.g., alcohol use, sedative use, perceived risk of opioid analgesic use).

 

Results: Approximately 11.0% of the sample reported past year pain reliever (opioid) misuse.  Young adults with a college or advanced degree (OR = 0.69, p = .015) and those who perceived pain reliever misuse to be riskier (OR = 0.21, p < .001) had lower odds of prescription pain reliever misuse. Young adults reporting more frequent marijuana use (OR = 1.02, p = .026), past year sedative misuse (OR = 3.79, p < .001), past year stimulant misuse (OR = 2.39, p < .001), and past year sleep medication misuse (OR = 3.77, p < .001) had greater odds of prescription pain reliever misuse. Gender, race, employment status, and frequency of binge drinking were unrelated to past year prescription pain reliever use in the multivariate model.

Conclusions & Implications: Findings suggest a sizable minority of young adults (11%) were engaged in misuse of prescription pain relievers and that the misuse of opioid analgesics and other substances (e.g. sedatives—including benzodiazepines, prescription sleeping medications) are correlated. Prevention and intervention efforts are needed to reduce opioid analgesic misuse, particularly given previous evidence that has linked opioid analgesic misuse with an increased risk of mortality and adverse psychiatric and health consequences (e.g. Boyd et al., 2016). Findings add to previous research in this area that has focused on college students and high-risk samples of youth. The current work highlights the need for social workers to help prevent and attend to risky patterns of substance misuse among young adults.