Usage Statistics within the United States in 2017

Introduction

For the misuse statistics associated with opioids in the United States, the main source utilized was the Substance Abuse and Mental Health Services Administration's 2017 report titled "Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health". This report, published in November 2018, includes statistics from this drug group's misuse in the past year, the misuse of the subtypes of pain relievers and the reason why they misused as well as where they sourced their drugs. It also talks about the statistics of those using opioids for the first time in 2017, always diving the numbers for pain relievers and heroin. Finally we'll explain Substance Use Disorders (SUDs) in the past year within the United States.

Past Year Opioid Misuse

Opioid misuse includes the misuse of prescription pain relievers or the use of heroin. It puts heroin into a separate category as it's not usually known as an opioid. In 2017, there were 11.4 million past year opioid misusers aged 12 or older, the vast majority of whom misused prescription pain relievers (Figure 20). Specifically, 11.1 million people aged 12 or older in 2017 misused prescription pain relievers in the past year compared with 886,000 people who used heroin. The majority of prescription pain reliever misusers had misused only prescription pain relievers in the past year and not used heroin (10.5 million). Approximately 562,000 people had misused prescription pain relievers and used heroin in the past year. About 324,000 people used heroin in the past year but had not misused prescription pain relievers. Although 5.1% of prescription pain reliever misusers also used heroin in the past year, 63.5% of heroin users also misused pain relievers in the past year.

In this figure opioid misuse is defined as heroin or prescription drug misuse. It is also worth to note that the percentages do not add up to 100% due to rounding of these.

As discussed beforehand, approximately 11.4 million people aged 12 or older in 2017 misused opioids in the past year (Figures 20 and 21). This number represents 4.2% of the population aged 12 or older. About 769,000 adolescents aged 12 to 17 misused opioids in the past year, which rounds to the estimate of 0.8 million people shown in Figure 21. This number corresponds to 3.1% of adolescents who misused opioids in the past year. About 2.5 million young adults aged 18 to 25 misused opioids in the past year, which corresponds to about 7.3% of young adults. An estimated 8.1 million adults aged 26 or older misused opioids in the past year, which represents 3.8% of adults in this age group.

In this figure, the numbers are correlated to the percentages seen in Figure 20. With this you can relate the numbers given by age groups to the whole group interviewed.

Past Year Heroin Use

An estimated 886,000 people aged 12 or older in 2017 used heroin in the past year (Figure 20). The estimate of past year heroin use in 2017 (0.3%) was higher than the estimates for most years between 2002 and 2011, but it was similar to the estimates in 2012 to 2015 (Figure 22).

In this figure what is being demonstrated is the past year heroin use among people aged 12 or older,
dividing the age groups with the different colors. Due to overlapping they add a table (Figure 22 Table)
that illustrates the data clearly. Difference between this estimate and 2017 estimate is significant at the 0.05 level.

With this figure you can see the date neatly distributed that is illustrated in Figure 22.
It shows the heroin use by age groups and from 2002-2017.

Aged 12 to 17

In 2017, 0.1% of adolescents aged 12 to 17 were past year heroin users (Figure 22). This percentage represents 14,000 adolescents who used heroin in the past year. The percentage of adolescents in 2017 who were past year heroin users was similar to or slightly lower than those in 2002 through 2016.

Aged 18 to 25

Among young adults aged 18 to 25 in 2017, 0.6% were past year heroin users (Figure 22). This percentage represents 214,000 young adults who used heroin in the past year. The percentage of young adults in 2017 who were past year heroin users was similar to those between 2005 and 2016 (ranging from 0.4 to 0.8%), but it was slightly higher than those in 2002 through 2004 (ranging from 0.3 to 0.4%).

Aged 26 or Older

In 2017, 0.3% of adults aged 26 or older were past year heroin users (Figure 22). This percentage represents 658,000 adults aged 26 or older who used heroin in the past year. The percentage of adults aged 26 or older in 2017 who were past year heroin users was similar from 2014 to 2016, but it was slightly higher than those in all years from 2002 to 2013.

Past Year Pain Reliever Misuse

Approximately 11.1 million people in 2017 misused prescription pain relievers in the past year (Figure 20), representing 4.1% of the population aged 12 or older (Figure 23). Among youths aged 12 to 17, 3.1%  misused prescription pain relievers, corresponding to 767,000 youths, which rounds to the estimate of 0.8 million shown in Figure 23. There were about 2.5 million young adults aged 18 to 25 who misused pain relievers in the past year, which corresponds to about 7.2% of young adults. An estimated 7.8 million adults aged 26 or older misused pain relievers in the past year, which represents 3.7% of adults in this age group.

In this figure, past year pain reliever misuse is seen both in numbers and percentages.
Within the numbers, the most observed are 26 or older but in percentages, 18-25 is the group with the highest impact.

Misuse of Subtypes of Pain Relievers

Respondents were asked in 2017 to identify the specific prescription pain relievers that they used in the past year. For each specific pain reliever that people reported using in the past 12 months, they were asked if they misused it. The specific pain relievers that individuals misused in the past year were categorized into subtypes. For example, respondents who reported the misuse of the pain relievers Vicodin® or hydrocodone were classified as misusers of hydrocodone products. This section presents estimates of the subtypes of pain relievers that were misused by individuals aged 12 or older.

In 2017, hydrocodone products were the most commonly misused subtype of prescription pain relievers, including: Vicodin®, Lortab®, Norco®, Zohydro® ER, and generic hydrocodone (Figure 24). An estimated 6.3 million people aged 12 or older misused these products in the past year, representing 2.3% of the population. An estimated 3.7 million people misused oxycodone products in the past year; this number represents 1.4% of people aged 12 or older. Oxycodone products include: OxyContin®, Percocet®, Percodan®, Roxicodone®, and generic oxycodone. An estimated 0.3% of people aged 12 or older misused buprenorphine products in the past year, which represents 766,000 people. About 261,000 people aged 12 or older (0.1%) misused methadone.

With prescription fentanyl products, 245,000 people reported misusing it in 2017, representing 0.1% of the population (Figure 24). Because NSDUH respondents were asked about the misuse of only prescription forms of fentanyl, this estimate for its misuse may under represent people who misused fentanyl that was illicitly manufactured in clandestine laboratories. This would be as opposed to the misuse of diverted fentanyl that was produced by the pharmaceutical industry. This estimate of fentanyl misuse also may not include people who misused illicitly manufactured fentanyl that was mixed with heroin or sold as heroin.

 This figure illustrates the type of opioids misused in 2017, excluding statistics for heroin.
It does not illustrate all the opioids described in the questionnaire. It shows the most relevant answers given.

Main Reasons for the Last Misuse of Pain Relievers

People who reported prescription pain reliever misuse in the past year were asked to recall the last prescription pain reliever that they misused. They were then asked to report the reason for misusing this prescription pain reliever that last time. Those who reported more than one reason for misusing the last prescription pain reliever were asked to report only the main reason. If they reported only one reason for misusing their last prescription pain reliever, then that reason was classified as the main reason for misuse.

Among people aged 12 or older in 2017 who misused prescription pain relievers in the past year, the most common main reason for their last misuse of a pain reliever was to relieve physical pain (62.6%) (Figure 25). According to the NSDUH definition, use without a prescription of one’s own or use at a higher dosage or more often than prescribed are both classified as misuse even if it was for the purpose of pain relief. Other common reasons were to feel good or get high (13.2%) and to relax or relieve tension (8.4%). Less common reasons among past year misusers of pain relievers included to help with sleep (5.4%), to help with feelings or emotions (3.6%), to experiment or see what the drug was like (2.8%), because they were “hooked” or needed to have the drug (2.2%), and to increase or decrease the effects of other drugs (0.7%). Some other reason was the main reason for misuse among 1.0% of past year misusers of pain relievers.

This figure illustrates the main reason people misused pain reliever in 2017,
excluding statistics for heroin. The percentages do not add to 100% due to rounding.

Source of the Last Pain Reliever That Was Misused

Among people aged 12 or older in 2017 who misused prescription pain relievers in the past year, the most common source for the last pain reliever they misused was from a friend or relative (Figure 26). More than half (53.1%) of people who misused pain relievers in the past year obtained the pain relievers the last time from a friend or relative. Specifically, 38.5% of people who misused pain relievers in the past year obtained pain relievers the last time by getting them from a friend or relative for free, 10.6% bought their last pain reliever from a friend or relative, and 4.0% took their last pain reliever from a friend or relative without asking.

About one third of people who misused pain relievers in the past year (36.6%) obtained pain relievers the last time through prescription(s) or stole pain relievers from a health care provider, typically getting the pain relievers through a prescription from one doctor (34.6%). About 1 in 18 people who misused pain relievers in the past year (5.7%) bought the last pain reliever they misused from a drug dealer or other stranger.

This figure illustrates the main source of the pain relievers taken people misused,
excluding statistics for heroin. People with unknown data for the source were excluded.

In this table, you can observe with more detail where the people surveyed
answered the source of the pain relievers they had used.

Substance Use Disorders in the Past Year

Substance use disorders (SUDs) represent clinically significant impairment caused by the recurrent use of alcohol or other drugs (or both), including health problems, disability, and failure to meet major responsibilities at work, school, or home. Respondents were asked SUD-related questions if they previously reported use in the past 12 months of any drugs described in the NSDUH questionnaire. These questions classify people as having an SUD in the past 12 months and are based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).

This figure illustrates an estimated number of people reporting SUD's as well as the number of
people misusing certain subtypes in 2017.The number reported are not mutually exclusive
as the people questioned could have misused more than one type of drug.

Pain Reliever Use Disorder

Pain reliever use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of pain relievers, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who misused pain relievers in the past 12 months were categorized as having a pain reliever use disorder if they met the DSM-IV criteria for either dependence or abuse for pain relievers. Dependence and abuse criteria for illicit drugs (including misused pain relievers) were described previously.

In 2017, an estimated 1.7 million people aged 12 or older had a pain reliever use disorder, which corresponds to 0.6% of people aged 12 or older (Figure 35). An estimated 0.4% of adolescents aged 12 to 17 had a pain reliever use disorder in the past year, which represents about 99,000 adolescents. Approximately 339,000 young adults aged 18 to 25 and 1.2 million adults aged 26 or older had a pain reliever use disorder in the past year. These numbers of adults with a pain reliever use disorder correspond to 1.0 percent of young adults and 0.6 percent of adults aged 26 or older.

This figure illustrates SUD's related to misuse of  pain reliever in 2017 by age group.
It compares the numbers in thousands and the percentages within the 1,678 that reported this.

Heroin Use Disorder

Heroin use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of heroin, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who used heroin in the past 12 months were categorized as having a heroin use disorder if they met the DSM-IV criteria for either dependence or abuse for heroin. Dependence and abuse criteria for illicit drugs (including heroin) were described previously. Approximately 652,000 people aged 12 or older in 2017 had a heroin use disorder. This number of people with a heroin use disorder represents 0.2% of people aged 12 or older (Figure 37). The percentage of people aged 12 or older in 2017 with a heroin use disorder was higher than the ones in 2002 to 2011, but it was similar to those from 2012 to 2016. Although there are significant differences, all percentages from 2002 to 2017 were 0.2 or less.

Aged 12 to 17

Less than 0.1% of adolescents aged 12 to 17 in 2017 had a heroin use disorder in the past year (Figure 37), which corresponds to about 4,000 adolescents. The percentage of adolescents in 2017 with a heroin use disorder was similar to the estimates in most years from 2002 to 2016.

Aged 18 to 25

Approximately 165,000 young adults aged 18 to 25 in 2017 had a heroin use disorder in the past year, which represents 0.5% of young adults (Figure 37). The percentage of young adults in 2017 with a heroin use disorder was greater than those seen in 2002 to 2008, but it was similar to the ones from 2009 to 2016.

Aged 26 or Older

In 2017, approximately 483,000 adults aged 26 or older had a heroin use disorder in the past year, which represents 0.2% of adults in this age group (Figure 37). Between 2002 and 2017, 0.1 to 0.2% of adults aged 26 or older had a heroin use disorder in the past year. The 2017 estimate was higher than the estimates in 2002 to 2012, but it remained steady when compared with the percentages between 2013 and 2016.

This figure illustrates an estimated number of people reporting heroin use disorders in percentages
 from 2002-2017. Differences between the estimates are statistically significant at the 0.05 level.

Opioid Use Disorder

Misuse of opioids include two categories of drugs: the use of heroin and the misuse of prescription pain relievers. NSDUH collects dependence and abuse information for these two categories of drugs. A respondent was classified as having an opioid use disorder if he or she met DSM-IV criteria for heroin use disorder or pain reliever use disorder, as described previously. In 2017, an estimated 2.1 million people aged 12 or older had an opioid use disorder, or 0.8 percent of people aged 12 or older (Figure 38). An estimated 0.4 percent of adolescents aged 12 to 17 had an opioid use disorder in the past year, which represents about 103,000 adolescents. About 445,000 young adults aged 18 to 25 had an opioid use disorder in the past year. This number corresponds to 1.3 percent of young adults. An estimated 1.6 million adults aged 26 or older had an opioid use disorder, which corresponds to 0.7 percent of adults in this age group.

This figure illustrates an estimated number of people reporting opioid use disorders in thousand vs. percentages in 2017. Opioid use disorder is defined as meeting DSM-IV criteria for both heroin or pain reliever disorder in the past year.