Many people who misuse prescription painkillers — meaning that they use these addictive medicines in ways not recommended by their doctor — may not think they have a problem, a new federal report suggests.

After all, survey respondents said, they wanted pain relief, not to get high. Or they got the medicine from a friend or relative, not on some street corner. Or they simply didn't believe that they had a drug problem.

Those findings, part of a broader compilation of data on mental health and substance use released on Monday, may help explain why the opioid epidemic has been so difficult to stop despite widespread public awareness of its mounting toll. Just last week came the news that an average of 13 Pennsylvanians died every day in 2016 of overdoses, mostly opioids.

Why Prescription Pain Relievers Are Misused ...

Almost two-thirds of people 12 and older who misused prescription pain relievers in 2015 said the main reason was for relief of physical pain.

... And Where They Are Obtained

More than half of those surveyed said the painkillers were given, bought, or taken without permission from a friend or relative. Only one in 20 said the painkillers were bought from a drug dealer or stranger.
Staff Graphic

"The most common reason for misusing prescription pain relievers is for relief of pain," said Beth Han, lead author of the report from the Substance Abuse and Mental Health Services Administration. More than 62 percent cited relief of physical pain. By comparison, 12 percent said in response to a national survey that their goal was to feel good or get high; 3 percent cited needing emotional help; and about 2 percent each said they were experimenting or were hooked.

In all, 12.5 million Americans age 12 and older misused opioid pain relievers — generally manufactured drugs that work much like naturally derived opiates such as heroin  — in 2015, according to SAMHSA's Behavioral Health Barometer for 2016.

The key is "misuse," which is defined as "use without a prescription of one's own; use in greater amounts, more often, or longer than told to take a drug; or use in any other way not directed by a doctor. Over-the-counter drugs are not included."

Another survey question asked where the misused medication came from. Half the respondents said they got it from a friend or relative, in most cases for free, and 34 percent more said the drugs were prescribed by one doctor. Just 5 percent bought them from a drug dealer or stranger; 4 percent took them from a friend or relative without asking; 2 percent got scripts from more than one doctor, an addiction-related behavior known as doctor-shopping; and less than 1 percent stole from a physician's office, clinic, hospital, or pharmacy.

Few thought they needed help. More than 82 percent of people with "illicit drug use disorder" — a psychiatric condition whose definition overlaps with addiction to legal as well as illegal drugs —  neither received nor "perceived a need" for specialty treatment. Addiction policy experts often note the lack of treatment beds as a major problem, and many families say that health insurance would not pay for the length of treatment that their loved ones needed. The survey, however, found that less than 7 percent of the 7.7 million Americans with illicit drug use disorder in the last year thought that they needed treatment but didn't get it (11 percent did).

The report included data on mental health and use of other substances, among them alcohol and cigarettes. Many of the findings were drawn from SAMHSA's National Survey on Drug Use and Health, released earlier.

The survey found that about one-third of 1percent of people age 12 and older (828,000 people) reported using heroin in the last year. Use among males (0.4 percent) was double that among females (0.2 percent). Use among people ages 18 to 25 was exactly double the national average (0.62 percent vs. 0.31 percent). About one-half of 1 percent of Americans ages 26 to 44 reported using heroin, with older age groups below the national average.

Heroin Use in the Last Year

An estimated 828,000 Americans age 12 and older (O.31 percent) reported using heroin.
National Survey on Drug Use and Health, 2015
An estimated 828,000 Americans age 12 and older (O.31 percent) reported using heroin.