Gender differences in prescription opioid use and misuse: Implications for men's health and the opioid epidemic

The majority of research on gender and the opioid epidemic focuses on women as patients, caregivers, or expectant mothers. However, little research approaches men as gendered subjects, despite their dramatically increased risk of opioid overdose. Accordingly, we examined gender differences in prescription opioid use and misuse with specific attention to implications for men using data from the 2017 National Survey on Drug Use and Health. We used design-adjusted, weighted Wald tests and multivariate logistic regression to compare gender differences in rates of prescription opioid use and misuse, prescription opioid sources, primary motivation for misuse, and prescription opioid dependence. We found that although men were significantly less likely than women to report opioid use, they were significantly more likely to report opioid misuse and to misuse prescription opioids primarily to feel good or get high. Among past-year opioid users, men were significantly more likely than women to meet DSM-IV criteria for opioid dependence. Results are consistent with past work on the intersection of masculinity norms and health behaviors. Although gender-specific interventions are typically synonymous with interventions tailored to women, our results suggest that such interventions could alleviate the burden of the opioid epidemic for men as well. Further research studying possible mechanisms that explain men's increased vulnerability to the opioid epidemic is urgently needed to address this growing public health crisis.