title: The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence - An assessment of demographic and substance use trends, United States, 2003-2014.
abstract: The harms related to nonmedical use of opioid analgesics have impacted the United States for more than a decade. Examining trends in nonmedical use, abuse, and dependence among various demographic and substance using groups can provide critical insight for prevention and treatment activities.
  
  
  
  Data from the National Survey on Drug Use and Health were used to assess trends in opioid analgesic nonmedical use, abuse, and dependence for 2003-2005, 2006-2008, 2009-2011, and 2012-2014. Multivariable logistic regression was used to identify characteristics associated with opioid analgesic abuse or dependence.
  
  
  
  Rates of past-year opioid analgesic nonmedical use decreased from 48.4 per 1000 persons aged 12years and older in 2003-2005 to 43.3 in 2012-2014. Declines were seen among most demographic and substance using groups. In contrast, rates of past-year opioid analgesic abuse or dependence increased from 6.0 per 1000 persons in 2003-2005 to 7.5 in 2012-2014; increases were seen among most demographic and substance using groups. In 2012-2014, odds of opioid analgesic abuse or dependence were highest among those with sedative or tranquilizer and heroin abuse or dependence.
  
  
  
  These findings indicate encouraging trends in overall nonmedical use of opioid analgesics which declined among many demographic and substance using groups. However, continued increases in rates of opioid analgesic abuse or dependence highlight the critical importance of maintaining efforts to drive down inappropriate opioid prescribing and expanding efforts to increase the provision of medication assisted treatment and psychosocial services for opioid use disorders and equipping individuals with naloxone to reverse opioid overdose.
authors: Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 200 Independence Ave SW, Room 434E2, Washington DC 20201, United States. Electronic address: Christopher.Jones@HHS.GOV.
authors: Christopher M
authors: CM
authors: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000701:Analgesics, Opioid; D002648:Child; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Nonmedical use; Opioid abuse; Opioid addiction; Overdose; Substance abuse; Substance use