Prescription opioid use is widespread. Here’s who is most vulnerable to misuse

Nearly 92 million adults in the United States used prescription opioids in 2015 — and while the vast majority of those individuals used the medications according to their prescriptions, some groups are particularly vulnerable to opioid use disorders, a new study finds.

The new report, published Monday in Annals of Internal Medicine, analyzed federal health data from more than 72,000 non-institutionalized, civilian adults in the U.S. The authors found that nearly 38 percent of those individuals used opioids in 2015. They then extrapolated their findings to the U.S. population as a whole.

The findings fill in a critical gap in information about the prevalence of prescription painkiller use and abuse in the U.S. Deaths from opioids have been rising dramatically for years, and there are now nearly 100 deaths a day from opioid overdoses.

Here’s a look at what the report found:

An estimated 11.5 million adults misused opioids in 2015. Misuse is a sweeping category that includes taking opioids without a prescription, taking them for a reason other than the condition for which they’re prescribed, or taking them at higher doses, more often, or for a longer period of time than prescribed.

Another 1.9 million adults had an opioid use disorder tied to prescription drugs in 2015. Opioid use disorder is diagnosed using a specific set of criteria. Among them: The use of opioids interferes with personal obligations at work, home, or school, and the user suffers withdrawal when stopping.

The new numbers don’t include opioid use disorders related solely to heroin use.

The prevalence of prescription opioid misuse and use disorders was higher among adults who’ve had suicidal thoughts and major depression. Adults who used prescription opioids and also had a major depressive episode had nearly twice the rate of prescription opioid misuse than those who hadn’t had a major depressive episode.

The most common motivation for misusing prescription opioids was to relieve physical pain. Two out of every three adults who misused prescription opioids in 2015 said they did so to deal with pain. The study’s authors said that drives home the point that “pain is a poorly addressed clinical and public health problem.”

Their conclusion: We need better prevention and treatment of the underlying disorders driving pain to reduce the rate of opioid misuse. Cutting down on access to opioids without offering alternative pain treatments won’t cut it, the authors argued.

“[That] could lead people to seek prescription opioids outside the health system or to use non-prescription opioids, such as heroin or illicitly made fentanyl,” they wrote.

Another 11 percent said they misused opioids to relax, and an additional 11 percent of adults reported doing so to get high.

The report also found that 60 percent of adults who misuse opioids don’t have their own prescription for the drugs. More than 40 percent of those who misuse painkillers say that the last time they misused opioids, a friend or relative gave them the medication for free.

The study’s authors said that suggests that in many cases, opioids are being prescribed in greater amounts than needed or for conditions the medications won’t really help to treat. That’s leading to a surplus of opioids that can be diverted to others.

Unemployed, uninsured, and low-income adults had a higher prevalence of both prescription opioid misuse and use disorders. Roughly 12 percent of adults who used prescription opioids and had an annual family income under $50,000 misused the medication, compared to 9 percent of those whose family income was $75,000 a year or higher.

Two key limitations to the study: It didn’t include homeless individuals who live outside of shelters, nor did it include incarcerated adults. But past research has shown homeless adults and those in the criminal justice system have a higher prevalence of substance use disorders than the rest of the population — which means the new report might underestimate the prevalence of opioid use disorders among disadvantaged adults.

Hispanic adults who took prescription opioids had the highest prevalence of misuse at 14 percent, compared to 9 percent of black adults and 10 percent of white adults who used prescription opioids. But interestingly, opioid use disorder was somewhat similarly prevalent across the racial and ethnic groups included in the study. Of those who took prescription opioids, 2.1 percent of Hispanic and white adults had an opioid use disorder, compared to 1.9 percent of black and non-Hispanic adults.

Men were more likely than women to misuse prescription opioids — 13 percent of men who took prescription painkillers in 2015 misused them, compared to just under 9 percent of women. Men were also twice as likely to have an opioid use disorder.