Nonmedical prescription opioid use is defined as any self-reported
use of prescription pain relievers that were not prescribed or that a
person takes for the experience or sensation they impart.
Nonmedical prescription drug use, particularly nonmedical use of
prescription opioids, has declined in the United States in recent years, yet is
still an important public health problem. Using prescription opioids
for recreational purposes alone costs the U.S. about $42 billion in lost
productivity, $8.2 billion in criminal justice costs, and $1 billion in
‘Unemployed workers have the highest risk of misusing prescription opioids, and those out of the workforce entirely were most at risk for misusing prescription stimulants.’
Researchers at Columbia University's Mailman School of Public Health
found that employment status is a factor in nonmedical use of
prescription opioids and prescription stimulants. Unemployed workers had
the highest risk of misusing prescription opioids, and those out of the
workforce entirely were most at risk for misusing prescription
The study is among the first to analyze the relationship between
employment status and nonmedical prescription drug-users over the age of
25 and show how social characteristics influence nonmedical
prescription drug use. The findings are published online in the journal Social Psychiatry and Psychiatric Epidemiology
Epidemiologist Silvia Martins, associate professor at the
Mailman School and senior author, sampled 58,486 adults 25 years and
older based on combined data from 2011 to 2013 from the National Survey
on Drug Use and Health.
People who were unemployed reported the highest odds of misusing
prescription opioids at 7%. Those out of the workforce reported
the highest odds of misusing prescription stimulants at 2%.
Overall, there were more users of nonmedical prescription opioids (3.5%) compared with nonmedical users of prescription stimulants.
"Our results confirm the need for adult prevention and deterrence
programs that target nonmedical prescription drug use, especially among
those unemployed or not in the workforce," said Dr. Martins. Of
particular concern are adults ages 26-34 who are unemployed, since the
odds of nonmedical prescription opioid use are higher in this age group
as compared to older adults.
The study also showed higher odds of prescription stimulants misuse
among those only employed part-time compared with persons employed full
time. "Our findings on these associations between employment status and
nonmedical prescription drug use parallel other research about emerging
adulthood and taking on new social roles, such as marriage and
parenthood," noted Martins.
The observation that unemployment is associated with a host of
diseases - mental disorders in particular, which Dr. Martins and
colleagues also found - is of utmost importance to those instituting
policies regulating control of nonmedical prescription drugs.
"Physicians, in particular, should be aware of patients' employment
status and the elevated risk between unemployment and non-medical drug
use and drug and mental disorders prior to prescribing," noted Dr.
Associations between employment status, and misuse of opioids and
stimulants yield important public health implications, says Martins. "By
improving our understanding of these associations and the role of
employment in drug use behaviors and modes of access, drug prevention
and deterrence programs can target users more effectively, especially
when combined with regulation."
Sensitivity to non-full-time employed people - a population that the
data suggests experiences greater social disadvantage - is imperative,
according to Martins. "Non-full-time employed people may suffer
disproportionately from the indirect harms of nonmedical use of
prescription opioids and stimulants insomuch that they have less family-
neighborhood-, and community-level social ties that would help mitigate
harms related to misuse. With substance use disorders increasingly
recognized as a public health issue - and not one of criminal justice - withholding social support, including treatment, from those with the
highest need will contribute to increasing social inequalities."