Individuals taking opioids were found to be more likely to report physical and mental health issues and to have more frequent dealings with the criminal justice system compared with individuals not taking opioids, according to the results of a study published in JAMA Network Open.

Investigators retrospectively reviewed survey responses from the 2015 to 2016 National Survey on Drug Use and Health. A total of 78,976 respondents, which represented 196,280,447 adults in the United States, were included in the analysis. Self-reported physical and mental health, substance use/misuse, and past year/lifetime involvement in the criminal justice system were the primary outcome measures, which were categorized according to increasing intensity of opioid use in the previous year.

In the weighted sample, 124,026,842 individuals reported no opioid use (63.2%; 95% CI, 62.6%-63.7%), 61,462,897 reported prescription opioid use (31.3%; 95% CI, 30.8%-31.8%),  8,439,889 individuals reported opioid misuse (4.3%; 95% CI, 4.1%-4.5%), 1,475,433 reported prescription opioid use disorder (0.8%; 95% CI, 0.7%-0.8%), and 875,386 reported having taken heroin (0.4%; 95% CI, 0.4%-0.5%) in the previous year.

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Increased opioid use intensity was associated with a higher likelihood of respondents reporting involvement with the criminal justice system (no opioid use, 15.9%; 95% CI, 15.4%-16.4%; prescription opioid use, 22.4%; 95% CI, 21.7%-23.1%; prescription opioid misuse, 33.2%; 95% CI, 30.9%-35.6%; prescription opioid use disorder, 51.7%; 95% CI, 45.4%-58.0%; and heroin use, 76.8%; 95% CI, 70.6%-82.1%).

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Of arrests reported in the respondents, 23% were attributable to violent crime (95% CI, 21.0%-25.0).Opioid use was not associated with more violent vs non-violent crime (prescription opioid use: odds ratio [OR], 1.1; 95% CI, 0.8-1.6; P =.59; prescription opioid misuse: OR, 1.4; 95% CI, 0.9-2.3; P =.11; prescription opioid use disorder: OR, 0.8; 95% CI, 0.3-2.1; P =.69; and heroin use: OR, 1.0; 95% CI, 0.5-2.0; P =.93).

The lack of information on the initiation of opioid use in relation to a respondent’s involvement with the criminal justice system represents a potential limitation of the study.

“Given the complex health and criminal justice profiles of individuals who use opioids, policy makers should carefully consider how changes to public health insurance programs and sentencing guidelines may aid or hinder a public health approach to the opioid epidemic,” concluded the study authors.


Winkelman TNA, Chang VW, Binswanger IA. Health, polysubstance use, and criminal justice involvement among adults with varying levels of opioid use. JAMA Network Open. 2018;1(3):e180558.

This article originally appeared on Clinical Pain Advisor