New U.S. data reveals significant disparities among groups, regions regarding prescription opioid use

March 21, 2023

Man sitting on bed, in pain

Photo by Andrea Piacquadio/Pexels

More than 30 million Americans – roughly 12 per cent of the U.S. population – rely on prescription opioids. A new Western-led study reveals high use among particular groups, including women and those who are food insecure; findings the researchers hope will aid policymakers and practitioners in addressing this important issue.

“Overall, prescription opioid use rates declined in the United States between 2019 and 2020, likely continuing a positive longer-term declining trend, but perhaps also due to the pandemic disrupting health care access,” said Anna Zajacova, a Western University researcher in the department of Sociology who led the study. “But despite the dip, use remains high for many population groups.”

Led by Western, the team included researchers from the University of Buffalo, New York University and Queen’s University.

Zajacova says before this research, little was known about current national prescription opioid use patterns in the U.S. across regions, city-urban divides, sociodemographic groups and pain levels.

“Our results provide a comprehensive portrait of up-to-date use prevalence and disparities,” she said.

In one of the largest, most comprehensive studies to date, the international team of researchers used National Health Interview Survey (NHIS) data to examine prescription opioid use in the general population in the U.S., as well as in adults with chronic pain and adults with high-impact chronic pain that alters daily life.

“By exploring these numbers in fine-grained detail, we’ve given policymakers and practitioners an evidenced-based blueprint to address prescription opioid use levels and patterns,” Zajacova said. “Our hope is these findings guide risk mitigation strategies and improve pain prevention and management for all Americans.”

The findings showed more than one in ten Americans in the general population reported using prescription opioids in the past 12 months and among Americans with pain, the prevalence was even higher – almost 30 per cent among those with chronic pain, and over 40 per cent with high-impact chronic pain.

Women showed a higher use of prescription opioids than men, but the researchers say this is likely due to their higher pain burden.

Food-insecure Americans reported 55 per cent higher prevalence of prescription opioids use compared to food-secure adults, and immigrants had considerably lower prescription opioid use than U.S.-born individuals.

Adults in the Southern U.S. had 41 per cent higher prescription opioid use prevalence, and the Midwest and West about 30 per cent higher prevalence, than peers in the Northeast.  These large regional differences perhaps suggest different approaches to pain management that could be targeted by education and policy changes.

Researchers found no difference when it came to an urban-rural divide in use.

The study, “Prevalence and Correlates of Prescription Opioid Use among U.S. Adults, 2019-2020,” was recently published in the journal PLOS ONE.