Article Figures & Data
Figures
- Figure 1.
Estimated number of adults with mental health disorders who use prescription opioids in the United States. All estimates are weighted to represent the U.S. noninstitutionalized population.
- Figure 2.
Estimated percentages of U.S. adults with and without mental health disorders who use prescription opioids, according to selected characteristics. All estimates are weighted to represent the U.S. noninstitutionalized population. Error bars represent 95% confidence intervals. Musculoskeletal conditions include all forms of arthritis, and other pain-related conditions.
- Figure 3.
Top 10 clinical diagnoses for prescription opioids among U.S. adults who have a mental health disorder. All estimates are weighted to represent the number of prescriptions among the U.S. noninstitutionalized population. The χ2 test was used to compare proportions.
Tables
- Table 1.
Sociodemographic Characteristics and Health Status of U.S. Adults According to Mental Health Disorder Status and Opioid Use
No Mental Health Disorder Mental Health Disorder P Value* P Value† Non–Opioid User (n = 42,908) Opioid User (n = 1,983) Non–Opioid User (n = 5,690) Opioid User (n = 1,310) No. of U.S. adults, millions 190.7 10.1 31.4 7.2 Sociodemographic characteristics Age, years <.001 <.001 18–44 49.4 29.7 40.0 25.1 45–64 32.7 42.0 39.8 51.9 ≥65 17.9 28.3 20.3 22.9 Sex .14 <.001 Male 51.2 45.8 34.8 32.2 Female 48.8 54.2 65.2 67.8 Race/ethnicity .03 <.001 Non-Hispanic white 62.8 74.1 79.3 80.6 Non-Hispanic black 12.2 13.5 7.1 8.2 Hispanic 16.5 8.7 9.4 6.8 Other or multiple races 8.4 3.7 4.1 4.5 Marital status <.001 <.001 Married 53.4 55.1 46.8 44.9 Divorced, separated, or widowed 17.9 28.4 27.6 40.3 Never married 28.7 16.5 25.5 14.9 Education <.001 .06 High school or less 56.3 63.5 53.9 67.9 Some college or bachelor's degree 27.5 25.8 28.2 24.5 Advanced degree 16.2 10.7 17.9 7.6 Health insurance <.001 <.001 Private 67.9 60.5 65.8 47.1 Public 15.8 30.7 23.4 45.7 Uninsured 16.3 8.7 10.8 7.2 Health status SF-12, mean (SE) PCS score 50.9 (0.08) 37.8 (0.47) 47.7 (0.20) 33.5 (0.50) <.001 <.001 MCS score 53.1 (0.06) 49.6 (0.32) 43.9 (0.20) 40.6 (0.40) <.001 <.001 Fair or poor overall health 8.8 32.2 21.0 54.3 <.001 <.001 Number of comorbidities <.001 <.001 0 89.0 72.8 78.3 58.2 1–2 7.9 15.9 15.4 23.7 ≥3 3.1 11.3 6.3 18.1 Data are percentages unless otherwise indicated. All estimates are weighted to represent the U.S. noninstitutionalized population. The χ2 test was used to compare proportions.
↵* P value compares nonopioid users with opioid users among adults with mental health disorders.
↵† P value compares adult opioid users with versus those without mental health disorders.
MCS, mental component summary; PCS, physical component summary; SE, standard error; SF-12, 12-item Short Form.
- Table 2.
Odds Ratios For the Association Between Independent Factors and Prescription Opioid Use
Independent Variables Odds Ratio (95% CI) Unadjusted Adjusted* Any mental health disorder 4.34 (3.93–4.77) 2.08 (1.83–2.35) Age, years 1.02 (1.02–1.02) 0.99 (0.98–1.00) Sex Male 1.00 (Reference) 1.00 (Reference) Female 1.42 (1.31–1.55) 1.07 (0.96–0.99) Race/ethnicity Non-Hispanic white 1.00 (Reference) 1.00 (Reference) Non-Hispanic black 0.83 (0.74–0.93) 0.80 (0.70–0.91) Hispanic or Latino 0.43 (0.38–0.49) 0.58 (0.49–0.67) Other 0.44 (0.35–0.56) 0.55 (0.42–0.72) Health insurance coverage Private 1.00 (Reference) 1.00 (Reference) Public 2.70 (2.44–3.00) 1.23 (1.06–1.42) Uninsured 0.64 (0.54–0.76) 0.86 (0.70–1.06) Has usual source of care 2.91 (2.49–3.39) 1.67 (1.39–2.02) PCS score 0.91 (0.91–0.91) 0.96 (0.95–0.97) Self-reported overall health status Excellent to good 1.00 (Reference) 1.00 (Reference) Fair or poor 6.02 (5.38–6.74) 1.29 (1.11–1.48) Self-reported limitation due to pain None or little 1.00 (Reference) 1.00 (Reference) Moderate 5.25 (4.50–6.13) 2.15 (1.78–2.59) Severe 15.24 (13.41–17.31) 3.15 (2.58–3.85) Physical limitation 8.25 (7.40–9.20) 1.84 (1.56–2.17) Has substance abuse diagnosis 4.29 (2.88–6.40) 2.42 (1.19–4.96) Had outpatient surgery 4.62 (3.98–5.36) 2.73 (2.22–3.36) Had inpatient surgery 7.02 (6.13–8.05) 3.58 (2.92–4.38) All estimates are weighted to represent the U.S. noninstitutionalized population.
↵* Adjusted for all other factors in the table.
PCS, physical component summary.
- Appendix Table 1.
Medical Expenditure Panel Survey Participants with Mental Health Disorders According to International Classification of Diseases, Ninth Revision, Clinical Modification Diagnosis Codes
ICD-9-CM Code Description Participants with Code, n (% among adults) 296 Episodic mood disorders 671 (1.3) 300 Anxiety, dissociative, and somatoform disorders 3,644 (7.0) 311 Depressive disorder 4,362 (8.4) ICD-9-CM, International Classification of Disease, Ninth Revision, Clinical Modification.
- Appendix Table 2.
Health Status of U.S. Adults According to Mental Health Disorder Status and Opioid Use
No Mental Health Disorder Mental Health Disorder P Value* P Value† Non–Opioid User (n = 42,908) Opioid User (n = 1,983) Non–Opioid User (n = 5,690) Opioid User (n = 1,310) Health status SF-12, mean (SE) PCS score 50.9 (0.08) 37.8 (0.47) 47.7 (0.20) 33.5 (0.50) <.001 <.001 MCS score 53.1 (0.06) 49.6 (0.32) 43.9 (0.20) 40.6 (0.40) <.001 <.001 Fair or poor overall health 8.8 32.2 21.0 54.3 <.001 <.001 Self-reported limitation due to pain <.001 <.001 None or little 84.6 40.2 69.4 21.2 Moderate 8.6 19.6 14.4 18.9 Severe 6.8 40.2 16.2 60.0 Smoker 15.2 24.9 22.4 36.7 <.001 <.001 Number of comorbidities <.001 <.001 0 89.0 72.8 78.3 58.2 1–2 7.9 15.9 15.4 23.7 ≥3 3.1 11.3 6.3 18.1 Self-reported limitation Any self-reported limitation 19.6 61.2 42.7 81.2 <.001 <.001 Physical limitation 8.3 40.1 21.0 59.3 <.001 <.001 Social limitation 2.8 18.7 11.7 36.0 <.001 <.001 Cognitive limitation 2.7 11.3 13.6 30.9 <.001 <.001 Healthcare use Has usual source of care 71.0 86.8 85.0 91.3 <.001 <.01 Had inpatient surgery 2.9 18.2 4.2 18.0 <.001 .93 Had outpatient surgery 3.6 17.5 6.1 13.7 <.001 .04 Had at least one ED visit for injury 15.3 41.5 25.1 43.5 <.001 .38 Data are percentages unless otherwise indicated. All estimates are weighted to represent the U.S. noninstitutionalized population. The t test was used to compare means, and the χ2 test was used to compare proportions.
↵* P value compares non–opioid users with opioid users among adults with mental health disorders.
↵† P value compares adult opioid users with versus those without mental health disorders.
ED, emergency department; MCS, mental component summary; PCS, physical component summary; SE, standard error; SF-12, 12-item Short Form.
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