Abuse of Pain Relievers: Results from the 2002

National Survey on Drug Use and Health (NSDUH)

Joe Gfroerer Office of Applied Studies

Substance Abuse and Mental Health Services AdministrationSeptember 9, 2003

2

NSDUH Design

• Representative nationally and in each State• Civilian, noninstitutionalized population• Aged 12 or older• Anonymous face-to-face interview• Computer-assisted interviewing• Part self-administered• 68,126 respondents in 2002

3

Impact of NSDUH Changes in 2002

• Increased reporting of substance use

• Data not comparable with prior surveys

4

Nonmedical Prescription Drug Use: NSDUH Definition

“Not prescribed for you”

OR

“You took the drug only for the experience or feeling it caused”

(Excludes OTC)

5

Pain Relievers Pillcard for 2002 NSDUH Questionnaire

6

Lifetime Nonmedical Use of Selected Pain Relievers, Age 12 or Older: 2002

0.9

1.0

1.1

1.9

2.1

2.9

4.5

6.9

9.7

13.1

18.9

0.0 5.0 10.0 15.0 20.0

Methadone

Ultram

Dilaudid

OxyContin

Morphine

Demerol

Hydrocodone

Codeine

Numbers (in Millions)

Darvocet®, Darvon®, or Tylenol® with Codeine

Vicodin®, Lortab®, or Lorcet®

Percocet®, Percodan®, or Tylox®

®

®

®

®

7

Nonmedical Pain Reliever Use, Age 12 or Older: 2002

1.54.4

10.9

29.6

0

5

10

15

20

25

30

35

(12.6% of population)

(1.9%)

(4.7%)

(0.6%)

Numbers (in Millions)

Lifetime Use

Past Year Dependence or

Abuse

Past Month Use

Past Year Use

8

Illicit Drug Dependence or Abuse, Age 12 or Older: 2002

0.15

0.18

0.21

0.43

0.44

0.51

1.49

1.51

4.23

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50

Sedatives

Inhalants

Heroin

Hallucinogens

Stimulants

Tranquilizers

Cocaine

Pain Relievers

Marijuana

Numbers (in Millions)

9

0.0

5.0

10.0

15.0

20.0

25.0

Lifetime Nonmedical Pain Reliever Use, by Age Group: 1965-2002

Aged 18-25

Percent Using in Lifetime

Aged 12-17

1965 1970 1975 1980 1985 1990 1995 2000

10

Lifetime Nonmedical Use of OxyContin®, Age 12 or Older: 1999-2002

1.9

1.0

0.4

0.2

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

1999 NHSDA 2000 NHSDA 2001 NHSDA 2002 NSDUH

Numbers (in Millions)

(0.1%)

(0.2%)

(0.4%)

(0.8%)

11

0

500

1,000

1,500

2,000

2,500

3,000

Annual Numbers of New Nonmedical Users of Pain Relievers: 1965-2001

Thousands of New Users

1965 1970 1975 1980 1985 1990 1995 2000

12

Lifetime Use of Selected Drugs among New Users of Pain Relievers

Nonmedically, Age 12 or Older: 200275

46

32

93

0

10

20

30

40

50

60

70

80

Percent of New Users

Marijuana OxyContin®CocaineHallucinogens Heroin

Note: New users are defined as persons who used pain relievers nonmedically for the first time in 1999, 2000, or 2001.

13

Lifetime Use of Other Drugs among Lifetime Nonmedical OxyContin® Users,

Age 12 or Older : 200298 98

89

79

27

0

10

20

30

40

50

60

70

80

90

100

Percent of Lifetime OxyContin® Users

Other Pain Relievers

Nonmedically

CocaineHallucinogensMarijuana Heroin

14

Lifetime Nonmedical Use of Pain Relievers among Lifetime Nonmedical OxyContin®

Users, Age 12 or Older: 2002

18.3

18.3

22.6

31.4

37.4

40.3

57.8

60.2

73.2

75.1

83.6

0.0 20.0 40.0 60.0 80.0 100.0

Dilaudid

Ultram

Methadone

Other

Demerol

Morphine

Codeine

Hydrocodone

Percent

Darvocet®, Darvon®, or Tylenol® with Codeine

Vicodin®, Lortab®, or Lorcet®

Percocet®, Percodan®, or Tylox®

®

®

®

15

1.0 0.9

1.4

2.6

0.6

1.0

0.6 0.6

0.3 0.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

Percent

Past Year Pain Reliever Dependence or Abuse

Aged 12-17Aged 18-25Aged 26-34Aged 35-49Aged 50 or Older

Lifetime Nonmedical OxyContin® Use

Rates of Pain Reliever Dependence or Abuse and Lifetime Nonmedical OxyContin® Use,

by Age Group, Age 12 or Older: 2002

16

0.7

1.0

0.6 0.6

0.0

0.2

0.4

0.6

0.8

1.0

1.2

Percent

MaleFemale

Lifetime Nonmedical OxyContin® Use

Past Year Pain Reliever Dependence or Abuse

Rates of Pain Reliever Dependence or Abuse and Lifetime Nonmedical OxyContin® Use,

by Gender, Age 12 or Older: 2002

17

0.7

1.1

0.4

0.1

0.9

0.3

0.0

0.2

0.4

0.6

0.8

1.0

1.2

PercentWhite, Not HispanicBlack/African American, Not Hispanic

Hispanic or Latino

Lifetime Nonmedical OxyContin® Use

Past Year Pain Reliever Dependence or Abuse

Rates of Pain Reliever Dependence or Abuse and Lifetime Nonmedical OxyContin® Use, by Race/Ethnicity, Age 12 or Older: 2002

18

Rates of Pain Reliever Dependence or Abuse and Lifetime Nonmedical OxyContin® Use,

by County Type, Age 12 or Older: 2002

0.6 0.6

0.9

1.2

0.5

0.7

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

Percent

Large MetroSmall MetroNonmetro

Lifetime Nonmedical OxyContin® Use

Past Year Pain Reliever Dependence or Abuse

19

Pain Reliever Dependence or Abuse among Lifetime Nonmedical Users of Any Pain Reliever,

OxyContin®, and Dilaudid®, Age 12 or Older: 2002

4.7

15.3

4.0

20.7

0.0 5.0 10.0 15.0 20.0 25.0

Users of OxyContin®

Percent with Pain Reliever Dependence or Abuse

Users of Pain Relievers, But Not OxyContin®

Users of Dilaudid®

Users of Pain Relievers,But Not Dilaudid®

20

Conclusions

• Nonmedical pain reliever and OxyContin® use increasing

• Nonmedical OxyContin® use mainly among abusers of other drugs

• OxyContin® and Dilaudid® users more likely to have dependence on or abuse of pain relievers than other nonmedical pain reliever users