Using data extracted from the 2015 National Survey on Drug Use and Health, a 2018 study published in the Journal of Clinical Psychiatry identified some key risk factors for prescription opioid misuse and opioid addiction. Knowing these risk factors could help doctors, counselors and addiction professionals better identify and treat those who misuse prescription opioids. The study included data from 51,200 adults.
Age and Gender
The study showed that adults ages 18–29 and 30-49 had an increased risk of opioid misuse. Among all age groups, men were more likely than women to develop an opioid use disorder. These results are consistent with other studies of both opioid and other drug and alcohol use disorders.
Those who self-identified as being in good-to-fair health were more likely than those who said that their health was excellent or very good to misuse opioids. This suggests that having worse health makes a person more likely to misuse opioids.
Education and Ethnicity
Individuals with no education beyond high school were more likely than those with higher education levels to misuse opioids. People of Hispanic origin were more likely than other ethnic or racial groups to misuse opioids.
Not having health insurance was associated with higher levels of opioid misuse. This could be because there are alternative pain treatments that are more expensive for those without insurance. Because opioids are relatively inexpensive, these drugs are used more often than alternative treatments to reduce pain among those without insurance or the financial means to afford other treatments like massage and physical therapy.
Suicidal ideation was associated with higher opioid misuse, as was past-month tobacco use and past-year use of other drugs — like cocaine, heroin, stimulants and sedatives — and alcohol. Lifetime cocaine use was also related to opioid misuse. Clinically speaking, most people who have an opioid use disorder also have another neurological condition, which may involve drugs, alcohol or another mental health problem.
The Motivation for Using Opioids
More than 60 percent of adults in the study reported that their motivation for using opioids was to relieve pain, with less than 12 percent saying that it was to get high and just under 11 percent saying that it was to relax. Since opioids are intended to relieve pain, the line between use and misuse is likely blurred for many users. Dependence may occur before many users realize what is happening and while they still think that they need the opioids for pain.
Many people who use opioids also use other legal and illegal drugs, including cannabis, heroin, cocaine and psychotropic medications. Motivations for using these other drugs were not part of the study, but researchers recommended that those with an opioid use disorder also be screened for other drug use, alcohol misuse and mental health conditions because of the prevalence of these in the study.