Prevalence and correlates of prescription opioid use among US adults, 2019–2020

We found POU prevalence of 11.9% in the general population, 29.3% among those with chronic pain, and 41.2% among those with high-impact chronic pain. Findings from fully-adjusted models include the following: In the general population, POU prevalence declined about 9% from 2019 to 2020 . POU varied substantially across US geographic regions: It was significantly more common in the Midwest, West, and especially the South, where adults had 40% higher POU than in the Northeast. In contrast, there were no differences by rural/urban residence. In terms of individual characteristics, POU was lowest among immigrants and among the uninsured, and was highest among adults who were food insecure and/or not employed. These findings suggest that prescription opioid use remains high among American adults, especially those with pain. Geographic patterns suggest systemic differences in therapeutic regimes across regions but not rurality, while patterns across social characteristics highlight the complex, opposing effects of limited access to care and socioeconomic precarity.