Friends and Family Enable Most Opioid Abusers

A new study by Yale School of Medicine reveals that nearly one third of those who use opioids for non-medical reasons obtain these drugs directly from physicians, but the majority get them from friends or family members. The study, which used data from the annual National Survey on Drug Use and Health, appears online in the Archives of Internal Medicine.

Over the past decade, prescribing of opioids, and the strengths of these drugs, have increased dramatically. From 2002 to 2006, sales of hydrocodone and oxycodone – the two most commonly prescribed opioid analgesics – nearly doubled. From 1997 to 2006, the strengths, as purchased in pharmacies, quadrupled. Furthermore, the number of people using opiods for non-medical reasons rose by 1.2 million – approximately 13 percent – between 2008 and 2009.

Because misuse of opioids is associated with addiction, overdose and death, the researchers set out to examine how people obtain them for non-medical purposes.

Nearly 31 percent of those who reported using opioids for non-medical reasons (e.g. to have a pleasurable experience) said they got the drugs from a physician.  Of the remainder, the majority obtained them from friends and family. In addition, analysis showed that for those aged 50 and older and for those with opioid analgesic abuse and/or dependence in the past year, there was an association with having a physician source of opioids.

The authors call for stronger public health efforts to mitigate non-medical opioid use among those who do not get their drugs from physicians, but from family members, friends, or drug dealers. Lead author William Becker, M.D., instructor of internal medicine at Yale School of Medicine, said, “Such an effort may help everyone, including those who get their opioids from the doctor.”

The study reveals that older age is a risk factor for obtaining non-medically used opioids from a physician. “Older patients visit doctors more often, and are more often seen for pain issues,” Becker said. “There is a continued need for physician and public health efforts to curb this increase in non-medical use of opioids.”

Other authors are Daniel G. Tobin, M.D. and David A. Fiellin, M.D. of Yale School of Medicine. The study was supported by grants from the National Institutes of Health.