Opioid-involved prescription drug misuse and poly-prescription drug misuse in U.S. older adults

Abstract

Objectives

Although older adult prescription drug misuse (PDM) is associated with concerning consequences, stimulant PDM and poly- PDM involving multiple medication classes each remain understudied. Our objectives were to examine PDM and poly-PDM prevalence by medication class in US older adults and to identify the mental health, SUD, and health-related quality-of-life correlates of poly-PDM.

Method

Data were from adults 50 and older completing the National Epidemiologic Survey on Alcohol and Related Conditions-III, (N = 14,667). Prevalence of PDM and poly-PDM by medication class was estimated. Logistic regression established odds of four SUD diagnoses, five psychopathology diagnoses and lifetime suicide attempts; linear regression evaluated health-related quality-of-life by PDM/poly-PDM status.

Results

Past-year PDM abstinence increased with age (50–54 years: 80.5%; 80 and older: 96.0%), while poly-PDM declined; past-year stimulant PDM was rare (≤0.6%), except when combined with opioid and tranquilizer/sedative PDM. Compared to no past-year PDM, both past-year opioid-only PDM and opioid-involved poly-PDM were associated with poorer health-related quality-of-life and greater odds of psychopathology and SUD, with the highest odds in poly-PDM.

Conclusion

The presence of any opioid-involved PDM in older adults highlights screening for SUD, psychopathology, and other medical conditions, with the most significant intervention needs likely in those with opioid-involved poly-PDM.

Keywords:

• Prescription drug misuse
• opioid
• benzodiazepine
• sedative
• older adult
• psychopathology
• substance use

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The data that support the findings of this study are available from the US National Institute on Alcohol Abuse and Alcoholism. Restrictions apply to the availability of these data, which were used under license for this study. Applications to use the data are available at https://www.niaaa.nih.gov/research/nesarc-iii/nesarc-iii-data-access.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse (NIDA) under Grant R01 DA043691; Grant R01 DA042146; Grant R01 DA036541; and Grant R01 DA031160. The NESARC-III was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The content is the authors’ responsibility and does not necessarily represent the views of NIDA or NIAAA.