Study Breaks Down Prescription Opioid Users

Types of Prescription Opioid Users

A 2019 study from the Columbia Mailman School of Medicine separated and analyzed prescription opioid users and misusers.  Researchers used data from a 2016-2017 national survey to group different categories of users and drug use.

The study delineates two overall groups, one of which they further break down into subcategories. Users refers to people who use prescription opioids as intended with their prescription. These are people who don’t overuse, sell to others, or use illicit opioids. Misusers contains the group of people who don’t follow their prescription and overuse or supplement with other opioids.

The study distinguishes between three types of misusers: with-prescription-only, without-prescription-only, and without-and-with-prescription. With-prescription-only misusers are described as people who only abuse the opioid they’re prescribed. The without-prescription-only category refers to people who have no medically qualified access to opioids, but they get them from someone who does, or they buy illegal opioids like heroin. The final category lumps the previous two together and identifies a group of people who have both a medical prescription for opioids, and also seek out opioids outside their prescription to abuse.

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The Breakdown

With the massive negative connotation surrounding the opioid epidemic, the study’s findings seem somewhat heartening. The survey found an overwhelming majority, 88% of respondents, take the appropriate amount of opioids for their prescription and don’t abuse them. While the group of misusers is much smaller, 12% of everyone prescribed opioids is a staggering amount of people. The CDC reports that in 2017 there were around 58 opioid prescriptions for every 100 Americans.

Out of the misusing population, the data reveals that just under 60% of them are with-prescription-only misusers. Within that 60%, 30% received their “prescription” form a non-medical source. The remaining 40% is shared somewhat evenly between without-prescription-only and with-and-without groups. The research not only classified the types of opioid use, but also found interesting behavior patterns displayed by the respondents.

Researchers found that without-prescription-only abusers received any prescription opioids from family or friends. Prescription misusing respondents also reported a lack of adequate pain relief as a driving factor behind finding more. This kind of overuse highlights the importance of good communication between doctor and patient to ensure their pain is being treated effectively and they’re following their prescription properly.

Both categories involving non-prescription based misuse showed higher rates of poly-substance use. This kind of use implies using substances outside of opioids like marijuana or benzodiazepines, and researchers note that mixing other substances with opioids can be extremely dangerous and predisposes the user to overdose. In 2016 nearly 42,000 deaths were related to opioid overdose, 40% of which involved prescription opioids. Out of all the different prescription opioids, the study found that hydrocodone, oxycodone, and tramadol are the three most commonly misused. Fentanyl is gaining popularity in illicit drug use, but its medical prescription is rare compared to the other opioids.

The researchers emphasize the importance of understanding different types of opioid abuse when attempting to remedy the opioid epidemic. Without an adequate understanding of why people are abusing these drugs or which drugs they’re abusing, any meaningful attempt at fixing the problem will be a guess. When 130 people die a day from opioid abuse in the US, guessing at solutions is not only irresponsible, but harmful.

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