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Understanding Who Opioid Users Are Underscores Challenges

This was published as a Wall Street Journal Think Tank column on December 19, 2016.

As deaths from opioid overdoses continue to rise, the 21st Century Cures Act has provided a billion dollars over the next two years to states for opioid prevention and treatment programs.

The new funding is sorely needed. To really be effective, the solutions to this epidemic, as with any drug epidemic, need to deal both with the suppliers and the users: in this case physicians who irresponsibly overprescribe painkillers and the people who get hooked on painkillers. A new survey of long-term opioid users by the Kaiser Foundation and the Washington Post underscores how challenging the problem is.

The users may not be who you think they are. You may know a 16-year-old skateboarder who ripped up his knee, has surgery, got some Vicodin from a physician or his parent’s medicine cabinet, and got hooked. But the typical long-term opioid user is not a kid getting high. The Kaiser-Washington Post survey found that six in 10 long-term opioid users were between 40 years old and 64 years old. Less than a quarter worked full time and 33% were on disability or retired (20%).

Seventy percent of long-term users said they have a debilitating disability or chronic disease. Long-term users are slightly more likely to live in rural areas; the problem of opioid overdoses is especially acute in rural America, where treatment is scarce and Emergency Rooms and jails can’t handle the problem.

Almost all long-term users of painkillers – 97% – received them from physicians, and both states and the federal government are taking steps to address overprescribing.

Virtually every long-term user  –  98% –  said they use opioids to relieve pain. More than four in 10 long-term users say they started taking painkillers for chronic pain, another 25% started because of pain after a surgery, and 25% because of pain after an accident or injury.

But a third (34%) of them said they also use them to get high, and another third (34%) said they also use them to deal with stress or relieve tension.

Significant percentages say the painkillers they take have had a positive effect on their health (42%) and on the quality of their lives (57%).

Opioids won’t simply disappear. If they did, you’d have to wonder how many long-term opioid users would turn to something else—either more or less harmful—just as some opioid users turn to heroin.

It is hoped that the new funding from the 21st Century Cares Act will enable states to do more both to clamp down on physicians who overprescribe opioids and to save the lives of people who overdose on painkillers.

The larger challenge is to address the causes of dependency among opioid users who, the survey shows, are turning to painkillers to cope with complex and very real challenges in their lives.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.