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Sources of opioid medication for misuse in older adults

results from a nationally representative survey

Schepis, Ty S.a,*; McCabe, Sean Estebanb; Teter, Christian J.c

doi: 10.1097/j.pain.0000000000001241
Research Paper

Despite increasing rates of prescription opioid (PO) misuse in adults 50 years of age and older, little research has investigated such misuse in this population. This work aimed to examine sources of misused opioid medication in adults 50 years and older, with comparisons to younger groups. Data were from the 2009 to 2014 National Survey on Drug Use and Health surveys. Prevalence rates of PO sources, misuse, and PO use disorder (POUD) symptoms were estimated. Design-based logistic regression investigated age-based differences in these factors and the association of sources with POUD symptoms and other concurrent substance use. Nearly half (47.7%) of adults 65 years and older used physician sources for past 30-day PO misuse, with the second highest rates in those 50 to 64 years old (39.2%). Conversely, use of theft (5.3%), purchases (8.5%), or friends/family (for free; 23.2%) to obtain opioids were least common in adults 65 years and older, with prevalence rates of these sources in those 50 years and older closer to those of younger groups. Across those 50 years and older, use of purchases, physician, or multiple sources were associated with elevated POUD symptom prevalence. Older adults, particularly those 65 years and older, use a different pattern of PO sources than adolescents or younger adults, and those using physician sources have elevated POUD symptoms. Physicians are a key avenue for older adults to obtain opioids for misuse, highlighting the potential role of clinicians in limiting such misuse.

Prevalence of physician source use for misused opioid medication was highest in older adults; 47.7% of misusers, 65 years and older, used a physician source.

aDepartment of Psychology, Texas State University, San Marcos, TX, United States

bCenter for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States

cDepartment of Pharmacy Practice, College of Pharmacy, University of New England, Portland, ME, United States

Corresponding author. Address: Department of Psychology, Texas State University, 601 University Dr, San Marcos, TX 78666, United States. Tel.: 512-245-6805; fax: 512-245-3153. E-mail address: (T.S. Schepis).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received January 03, 2018

Received in revised form March 16, 2018

Accepted April 03, 2018

© 2018 International Association for the Study of Pain
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