Columbia: 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 stimulants. 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, MD, PhD, 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 percent. Those out of the workforce reported the highest odds of
misusing prescription stimulants at 2 percent. Overall, there were more
users of nonmedical prescription opioids (3.5 percent) compared with
nonmedical users of prescription stimulants (.72 percent).
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.
prescription drug use, particularly nonmedical use of prescription
opioids, has declined in the U.S. 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
“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.
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
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.”
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.”
Alexander S. Perlmutter (first author), Mailman School of Public Health
and Centre de Recherche Epidemiologie et Statistique, Sorbonne,
Universite´ Paris Descartes, Hopital Hotel-Dieu; Sarah C. Conner, Boston
University School of Public Health; June H. Kim and Luis E. Segura,
Mailman School of Public Health; and Mirko Savone, Mailman School of
Public Health and Department of Pediatric Hematology, Oncology and Stem
Cell Transplantation, Columbia University Medical Center.
study was supported by the U.S. National Institutes of Health, National
Institute of Drug Abuse, grants R01DA037866, R01DA039454,
5T32DA031099-04, the Eunice Kennedy Shriver National Institute of Child
and Human Development, R01HD060072, and Columbia University President’s
Global Innovation Fund.