How People Obtain the Prescription Pain Relievers They Misuse

Authors

Introduction

Misuse of prescription pain relievers is, after marijuana use, the second most common form of illicit drug use in the United States.1 When used appropriately under medical supervision, pain relievers such as hydrocodone (e.g., Vicodin®), oxycodone (e.g., OxyContin®), and methadone can be medically beneficial by reducing pain and suffering. Most of the 97.5 million people aged 12 or older in the United States who used pain relievers in the past year did not misuse the pain relievers they took; 12.5 million people reported that they misused pain relievers in the past year.2 Combined 2013 and 2014 National Survey on Drug Use and Health (NSDUH) data are used in this analysis because the questions needed to categorize prescription pain reliever misusers by their frequency of use were removed in the 2015 NSDUH questionnaire redesign. When taken without a physician's direction and oversight, these medications can cause serious adverse consequences and can lead to a substance use disorder, overdose, or death.3,4 Given the prevalence of prescription drug misuse, it can be useful for prevention specialists, policymakers, and health care providers to understand the sources of the prescription drugs that are misused and whether these sources differ based on the type of user misusing the substance.

NSDUH is a nationally representative annual survey of approximately 67,500 people aged 12 or older throughout the United States. NSDUH is a primary source of information on the scope and nature of many substance use and mental health issues affecting the nation. NSDUH asks respondents questions related to their nonmedical use of prescription-type pain relievers during the past year. Nonmedical use (hereafter referred to as misuse) is defined as the use of prescription-type drugs not prescribed for the respondent by a physician or used only for the experience or feeling they caused.5 NSDUH also asks people who misused prescription pain relievers in the past year how they obtained prescription pain relievers the last time they used them6 and how many days in the past year they used prescription pain relievers for nonmedical purposes. In this issue of The CBHSQ Report, past year misusers are categorized into three mutually exclusive groups: (1) recent initiates, (2) frequent users, and (3) occasional users. Recent initiates are defined as those who initiated misuse of prescription pain relievers in the past year. Occasional users are defined as those who were