How many people physically dependant on opioids live in the US?
August 17, 2013 12:31 PM

For some odd reason, I can only find statistics estimating the amount of regular heroin users in the US. I'm interested in all opioid based medications, both legal and illicit, prescription or otherwise. I'm interested in both people who are addicted and those who are physically dependent due to pain management. Do reliable statistics exist that encompass this entire population?

I've been reading up on the period of history known as The Great Binge (1870-1914) in which patent medicines were abundant, laudanum was freely sold over the counter and morphine/heroin based cough syrups and other opiate formulations were freely handed out to women and children for minor things like menstrual cramps and colic. According to the sources I've encountered, an estimated 150,000-200,000 opiate addicts lived in the US at the time, mostly women.

Considering how accessible, widespread and socially acceptable opium, morphine, and heroin concoctions were at this time, this number seems rather low. I'm starting to wonder if there are really less people dependent on opioid based medications today as a fraction of the total population, despite the regulations in place.
posted by WhitenoisE to Society & Culture (2 answers total) 1 user marked this as a favorite
Try searching Pubmed. Searching for "opioid abuse statistics" and then narrowing to review articles only returns a ton of hits, including this useful-looking article in Pain Physician.

A lot of the stuff you're going to find on there is available only with institutional access, so if you find a particularly juicy-looking article abstract feel free to memail me and I'll see if I can pull it down for you.
posted by killdevil at 2:15 PM on August 17, 2013


I think you're going to run into problems with definitions when trying to research this, because people taking legally prescribed prescription painkillers are not, by most current medical/psychological definitions, "dependent" on the painkillers. And then it seems that most drug policy agencies separate abuse of legal drugs from abuse of illegal drugs.

So I think you're going to need to separate out medical use of prescription meds, non-medical use of prescription meds, and abuse of illegal drugs.

The bits that I've been able to piece together:

EPIDEMIC: RESPONDING TO AMERICA’S PRESCRIPTION DRUG ABUSE CRISIS from the White House says that "by 2009, 257 million [opioid painkiller] prescriptions were dispensed."

State Estimates of Nonmedical Use of Prescription Pain Relievers from SAMHSA states that "Combined 2010 and 2011 (hereafter "2010-2011") data indicate that about 1 in 22 (4.6 percent) persons aged 12 or older nationwide reported having used pain relievers nonmedically in the past year." So that's 4.6% of about 300,000,000 (subtracting out people under 12, which I'm guessing at to make the numbers round), or 13,800,000.

You said you could find heroin numbers, but just to be thorough, SAMSHA reports, "The number and percentage of persons aged 12 or older who were current heroin users in 2011 (281,000 or 0.1 percent) were similar to those from 2006 through 2010."

I'm not finding other illegal drugs listed by name anywhere, and it looks like Opium is the only one the DEA even measures separately, so I'm guessing it's not a huge number.

So you've got about 14 million people using opiates illegally or non-medically, and another 257 million prescriptions legally dispensed. Of the legal prescriptions, obviously some (most?) of them would be for short-term use, and some (most?) of them would be converted into illegal/non-medical use. The 2013 press release for "Long-Term Use of Prescription Painkillers for Back Pain Linked to Erectile Dysfunction in Men" says, "Another recent survey, published in the journal Pain, estimates 4.3 million adults in the U.S. use these opioid medications on a regular basis."

So my non-scientist, non-medical-researcher estimate, based on these sources, would be about 18 million people in the US are either long-term medical users of prescription opioid medications, non-medical users of prescription opioid medications, or abusers of illegal opioid drugs, which is about 5-6% of the US population.

(I'm also not a mathematician, so anyone should feel free to correct my math.)
posted by jaguar at 2:27 PM on August 17, 2013


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