Session: Opioid and Other Nonmedical Prescription Drug Use in the United States: Contemporary Trends in Use, Co-Use, and Correlates to Identify Opportunities for Prevention (Society for Prevention Research 27th Annual Meeting)

The recent epidemic involving overdose deaths has elevated opioid misuse as a top national priority. More than 20% of patients prescribed opioids for chronic pain misuse them and 8-12% report an opioid use disorder. Opioid misuse has implications for escalating to heroin as well, as 5% who misuse opioids transition to heroin and approximately 80% of individuals who use heroin first misuse prescription opioids. Further, overdoses are rapidly increasing (30% overall), especially in the Midwest and in urban areas. While medication-assisted treatment (MAT) is available, research that informs the prevention of opioid use is needed.

Data from the 2017 National Survey on Drug Use and Health show that the number of first-time heroin users was down to about 81,000, less than half the number in 2016. However, 2 million individuals misused prescription painkillers for the first time during 2017. This symposium presents three empirical studies that shed light on opioid and other nonmedical prescription drug (NMPD) use, co-use with alcohol and marijuana, and correlates such as experiences of pain. At the heart of each study is innovative analysis of contemporary data on opioid use that can further our understanding of the underpinnings of this epidemic and point to new opportunities for prevention and intervention. The first two talks present findings from the Population Assessment of Tobacco and Health (PATH) study, a large, longitudinal cohort study spanning ages 12-90. The third talk relies on restricted use, county-level data on opioid overdose deaths and opioid treatment facilities, as well as state-level information on opioid laws.

The first talk applies an innovative approach, weighted time-varying effect modeling (TVEM), to document current epidemiologic trends in NMPD use across ages 12-90. Age trends in the link between drug use and racial/ethnic group, sex, and level of pain are examined. The second talk delves more deeply into age trends in co-use of marijuana and heavy episodic drinking and the associated risk for NMPD use. The third talk uses Bayesian hierarchical models to examine the impact of state-level prescription drug monitoring programs (PDMPs) on county-level opioid overdose-related deaths, and how the impact of PDMPs on overdose deaths varies by local access to opioid treatment facilities that provide access to MAT. The discussant is an expert in the developmental course and stages of substance use disorders and the development and testing of interventions that rely on combinations of current evidence-based techniques. He will integrate implications of the studies and suggest future opportunities to use existing data to advance opioid use prevention research.