Prescription Opioid Misuse Among Individuals with Multiple Chronic Conditions

Background and Purpose: Prescription drug misuse, or any use of a prescription medication in a way that is not prescribed or directed by a doctor, remains a growing concern in America. Although some studies have shown that having multiple chronic conditions (MCCs) may reduce the likelihood of an individual misusing prescription drugs compared to individuals who have one or no MCCs, little is known about how prescription drug misuse rates differ between age groups among individuals with MCC. Therefore, this study aims to examine the effect of multiple chronic conditions on the likelihood of having misused a prescription opioid among younger and older adults.

Methods: Data for this study comes from the combined 2017 through 2019 National Survey on Drug Use and Health (NSDUH), an annual survey of adolescents and adults. The sample was a combined n=166,413 across the 3 years. Age was categorized into two groups: individuals under 50 and 50 and over. Multiple chronic conditions were coded for any individual with two or more of the following conditions: diabetes, COPD, cirrhosis, hepatitis, kidney disease, asthma, HIV/AIDS, heart conditions, high blood pressure, or any type of cancer. Logistic regression was used to examine the effect of having MCCs on the likelihood of misusing prescription pain relievers, including an interaction term for MCC by age group.

Results: Around 52.1% of the sample was female, with 58.1% identifying as non-Hispanic white. Among adults 50 and over, 2.4% had misused a prescription opioid in the past year, while 5.1% of adults under 50 had misused a prescription opioid. Additionally, around 3.9% of people under 50 had multiple chronic conditions, while nearly 26% of adults over 50 had multiple chronic conditions. For the whole sample, having multiple chronic health conditions increased the odds of misusing a prescription pain reliever by around 32% (OR= 1.32, p < 0.05, CI= 1.24 – 1.42). However, a significant interaction effect was observed between the age group and multiple chronic conditions. Older adults with MCCs showed around a 23% increased likelihood of having misused a prescription opioid compared to older adults without MCCs (OR= 1.23, p < 0.05, CI= 1.07 – 1.41), while younger adults with MCCs showed a 70% increase in likelihood compared to younger adults without MCCs (OR= 1.70, p < 0.05, CI= 1.57 – 1.85).

Conclusion and Implications: Findings from this study indicate that individuals with multiple chronic health conditions are more likely to misuse a prescription pain reliever than individuals without MCC, and this effect is significantly larger for adults under 50 years old. Although younger adults are less likely to have multiple chronic health conditions, they represent a high-risk group for potential prescription pain reliever misuse.