Gender and non-medical use of prescription opioids: results from a national US survey.

AIMS: Gender differences exist regarding alcohol and illicit drug use disorders in the United States. Little is known about the gender-related factors associated with non-medical use of prescription opioids.

DESIGN: Using data from the 2003 National Survey on Drug Use and Health, we examined risk factors for past-year non-medical use of prescription opioids stratified by gender.

SETTING: Non-institutionalized US residences. Participants Civilian, non-institutionalized US citizens aged 12 years and older.

MEASUREMENTS: Self-reported alcohol and drug use, focusing specifically on past-year non-medical use of prescription opioids.

FINDINGS: Among 55 023 respondents, 4.8% reported past-year, non-medical use of prescription opioids. For both women and men, alcohol abuse/dependence and marijuana, hallucinogen, cocaine, non-medical stimulant and sedative/tranquilizer use were associated with past-year non-medical use of prescription opioids. Among women but not men, first use of illicit drugs beginning at 24 years or older [adjusted odds ratios (AOR) 1.90, 95% CI 1.05-3.44], serious mental illness (AOR 1.67, 95% CI 1.29-2.17) and cigarette smoking (AOR 1.33, 95% CI 1.05-1.68) were associated with past-year non-medical use of prescription opioids. Among men but not women, past-year inhalant use (AOR 1.93, 95% CI 1.28-2.92) was associated with the outcome.

CONCLUSIONS: For both women and men, illicit drug use is associated with the non-medical use of prescription opioids. Additionally, certain factors associated with the non-medical use of prescription opioids are notably gender-specific. Clinicians should recognize that patients with a history of illicit substance use or misuse of other prescription medications are at increased risk for non-medical use of prescription opioids, and that gender-specific factors can help to identify individuals at greatest risk.