Examining Correlates and Motives for Prescription Opioid Misuse Using the National Survey on Drug Use and Health: Do Older and Younger Adults Differ?

Background

Prescription opioid misuse is a significant health and social problem affecting American older adults, yet research has disproportionately focused on younger adults.

Objectives

(1) To compare correlates of prescription opioid misuse among younger and older adults; and (2) To examine whether older age is associated with pain relief as a motive for misuse.

Methods

Using the combined 2021, 2022, and 2023 National Survey on Drug Use and Health, chi-square and multivariable logistic regression analyses were conducted to examine correlates of opioid misuse among adults aged 18-49 (n = 107,755) and 50+ (n = 31,706). Additional analyses were conducted to examine whether older age is associated with pain relief as a motive for misuse (n = 4303).

Results

The prevalence of past-year prescription opioid misuse was 3.7% among adults aged 18-49 and 2.6% among adults aged 50+. Correlates of prescription opioid misuse among both age cohorts included having a low household income, poor self-rated health, a history of depression, and having a past-year alcohol or cannabis use disorder. Being divorced and lower levels of education were associated with misuse among younger adults, but not older adults. Older age was associated with pain relief as a motive for misuse at the bivariate level, but was no longer significant in the multivariable analysis. In the multivariable analysis, those with a past-year alcohol or cannabis use disorder were less likely to report pain relief as a motive for misuse.

Conclusions

Knowledge of correlates of misuse can help inform targeted screening and treatment to support people with opioid misuse.