Pain Pract. 2025 Jul;25(6):e70057. doi: 10.1111/papr.70057.
ABSTRACT
BACKGROUND: Medication sources for prescription opioid misuse in US adolescents and young adults may have changed, particularly related to the COVID-19 pandemic. We examined how opioid sources vary across age groups and cohorts and whether links between sources and substance use or mental health vary between age groups.
METHODS: Cross sectional nationally representative survey data from the 2015-2019 and 2021-2022 National Survey on Drug Use and Health were used. Respondents were interviewed in their homes (2015-19) or via mixed household and web-based survey methods (2021-2022). Participants were 6045 14-25-year-old reporting past-year prescription opioid misuse. Mutually exclusive opioid sources were physicians, purchases, theft, and friends/family for free. Cross-tabulations estimated source prevalence by age, and logistic and negative binomial regression models evaluated links between sources (independent variable) and substance use, mental health, and sociodemographics (individual dependent variables).
RESULTS: Theft declined significantly with age in the 2015-2019 cohort (12.4% to 4.7%), with some evidence of opioid source differences between 2015-2019 and 2021-2022. Those using purchases had the most past-month prescription opioid misuse days and the highest prevalence of substance use disorder from misuse (e.g., 23.4% of 2015-2019 young adults), other substance use, and mental health concerns; those using theft typically had the second highest rates, with the lowest rates often in the physician source group.
CONCLUSION: We found age- and cohort-based differences in sources, and mechanisms underlying these differences warrant further study. Adolescents and young adults using purchases or theft to obtain opioids are important targets for identification and intervention.
PMID:40542613 | DOI:10.1111/papr.70057
