The epidemiology of prescription fentanyl misuse in the United States. (September 2019)

• Record Type: Journal Article
• Authors: Schepis, Ty S.; McCabe, Vita V.; Boyd, Carol J.; McCabe, Sean Esteban
• Is Part Of: Addictive behaviors. Volume 96(2019)
• Page Start: 89
• Page End: 93
• Publication Date: 2019-09
• Subjects: Prescription fentanyl -- Opioid -- Misuse -- Epidemiology; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2019.04.022
• Languages: English
• ISSNs: 0306-4603

Abstract

Abstract: Background: US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to elevated overdose and mortality risk. This work aimed to fill that gap through analyses of prescription fentanyl misuse correlates. Methods: Data were from the 2015–16 National Survey on Drug Use and Health (N = 114, 043), a nationally representative survey of the non-institutionalized US population. Respondents were (all past-year): those misusing prescription fentanyl (PF); those misusing other (non-fentanyl) prescription opioids (NFPO); and population controls. Respondent groups were compared using multinomial regression on sociodemographics, physical health, mental health and substance use. The PF and NFPO misuse groups were compared on opioid misuse characteristics, using logistic regression. Results: An estimated 4.4% misused NFPO, and 0.1% misused PF (past-year). Past-year heroin use was more common in those who misused PF (44.3%) than those who misused other NFPO (4.4%; relative risk ratio [RRR] = 7.1, 95%CI = 3.7–13.9) or population controls (0.1%, RRR = 35.1, 95%CI = 17.3–71.1). Non-alcohol substance use disorder (SUD) was similarly elevated in those who misused PF (78.7%) versus the other NFPO group (27.5%, RRR = 3.8, 95%CI = 1.8–8.2) or population controls (1.6%, RRR = 20.6, 95%CI = 9.4–45.5). Conclusions: Respondents who misused prescription fentanyl were both more drug-involved generally and opioid-involved specifically; and likely need a combination of significant interventions and monitoring for their polysubstance use. Highlights: This study aimed to identify the correlates of past-year fentanyl misuse in the US. Heroin use (44.3%) and SUD (38.2%) often occurred with past-year fentanyl misuse. This group also had very high rates of non-alcohol substance use disorder (78.7%). Fentanyl misuse was associated frequent prescription opioid use disorder (53.7%). Those with past-year fentanyl misuse are heavily opioid and polysubstance involved.