Ty S Schepis1, Linda Wastila2, Beth Ammerman3, Vita V McCabe3,4, Sean Esteban McCabe3,5,6,7,8. 1. Department of Psychology, Texas State University, San Marcos, Texas. 2. Peter Lamy Center on Drug Therapy and Aging, and Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland. 3. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan. 4. St. Joseph Mercy Ann Arbor, St. Joseph Mercy Health System, Ypsilanti, Michigan. 5. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan. 6. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan. 7. Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA. 8. Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVES: To evaluate age-based differences in prescription opioid misuse (POM) motives and to evaluate substance use and mental and physical health correlates of POM motive categories in older adults. DESIGN: Data were from the National Survey on Drug Use and Health (NSDUH), a nationally representative US survey. SETTING: The NSDUH is a household survey. SUBJECTS: A total of 5,826 US residents with past-year POM; 415 were 50 years and older (7.1%). METHODS: Nine POM motives were assessed among those engaged in past-year POM, grouped into three categories: solely physical pain relief, solely non-pain relief, or mixed motives. Prevalence of POM motives were calculated by age group, with logistic models examining age-based differences. Finally, odds of substance use and mental and physical health correlates by motive category were calculated via logistic models in older adults. RESULTS: POM motivated solely by physical pain relief increased from 35.1% in young adults to 65.4% in older adults; in older adults, 84.7% of POM episodes involved pain relief as a motive. POM for solely non-pain relief or mixed motives was associated with greater odds, vs pain relief only, of past-year benzodiazepine misuse (odds ratio [OR] = 4.43 and 6.15, respectively), any substance use disorder (OR = 5.57 and 5.60, respectively), and suicidal ideation (OR = 4.05 and 3.56, respectively) in older adults. CONCLUSIONS: . POM motives change over the lifespan, with increasing POM for pain relief with aging. Comprehensive nonopioid pain management is needed for those engaged in POM for pain relief, and substance use and mental health treatment are needed for those with non-pain relief motives.
OBJECTIVES: To evaluate age-based differences in prescription opioid misuse (POM) motives and to evaluate substance use and mental and physical health correlates of POM motive categories in older adults. DESIGN: Data were from the National Survey on Drug Use and Health (NSDUH), a nationally representative US survey. SETTING: The NSDUH is a household survey. SUBJECTS: A total of 5,826 US residents with past-year POM; 415 were 50 years and older (7.1%). METHODS: Nine POM motives were assessed among those engaged in past-year POM, grouped into three categories: solely physical pain relief, solely non-pain relief, or mixed motives. Prevalence of POM motives were calculated by age group, with logistic models examining age-based differences. Finally, odds of substance use and mental and physical health correlates by motive category were calculated via logistic models in older adults. RESULTS: POM motivated solely by physical pain relief increased from 35.1% in young adults to 65.4% in older adults; in older adults, 84.7% of POM episodes involved pain relief as a motive. POM for solely non-pain relief or mixed motives was associated with greater odds, vs pain relief only, of past-year benzodiazepine misuse (odds ratio [OR] = 4.43 and 6.15, respectively), any substance use disorder (OR = 5.57 and 5.60, respectively), and suicidal ideation (OR = 4.05 and 3.56, respectively) in older adults. CONCLUSIONS: . POM motives change over the lifespan, with increasing POM for pain relief with aging. Comprehensive nonopioid pain management is needed for those engaged in POM for pain relief, and substance use and mental health treatment are needed for those with non-pain relief motives.
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