{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T10:53:56Z","timestamp":1778669636052,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"VA Office of Academic Affiliations"},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["T35AA023760"],"award-info":[{"award-number":["T35AA023760"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Clinician Scholars Program"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1 TR001864"],"award-info":[{"award-number":["TL1 TR001864"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Recent changes to the US opioid overdose epidemic have been driven by the spread of illicitly manufactured opioids and complex patterns of multisubstance use. Updated analyses of opioid use epidemiology among US adults are needed to guide new research and interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Cross-sectional study of 2021 to 2022 National Survey on Drug Use and Health. Using nationally representative estimates weighted to 255\u2009053\u2009169 adults, multivariable logistic regression models determined odds of mutually exclusive past-year opioid use categories (nonmedical use of pharmaceutical opioids [NMUPO], heroin use, or both) across demographic, socioeconomic, and clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Prevalence of NMUPO among US adults was 3.0%, heroin use 0.2%, and both 0.2%. Demographic characteristics associated with nonmedical opioid use included middle age groups (e.g., 35-49\u2009years old relative to 18-25\u2009years old, NMUPO: adjusted odds ratio [aOR] 1.61, 95% CI 1.26-2.07) and LGB sexual orientation relative to heterosexual orientation (e.g., NMUPO: aOR 1.33, 95% CI 1.09-1.64). Among socioeconomic variables, the strongest associations were with lower educational attainment (e.g., completing high school relative to completing college, both: aOR 3.84, 95% CI 1.53-9.68). Clinical variables strongly associated with opioid use included nonmedical sedative\/tranquilizer use (e.g., NMUPO: aOR 7.48, 95% CI 5.86-9.56), nonmedical stimulant use (e.g., both: aOR 32.42, 95% CI 17.11-61.42), lower self-rated health (e.g., \u201cpoor\u201d health relative to \u201cexcellent\u201d health, NMUPO: aOR 1.98, 95% CI 1.34-2.91), and severe mental illness (e.g., both: aOR 3.78, 95% CI 2.05-6.96).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Future research and public health efforts should account for heterogeneity in opioid use patterns across US adults, including strong associations with nonopioid substance use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342251348150","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T11:32:38Z","timestamp":1752665558000},"page":"38-48","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Demographic, Socioeconomic, and Clinical Variables Associated With Nonmedical Pharmaceutical Opioid Use and Heroin Use Among US Adults in 2021 to 2022"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9458-7628","authenticated-orcid":false,"given":"Max L.","family":"Moss","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele J.","family":"Buonora","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"},{"name":"National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA"},{"name":"Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA"},{"name":"General Internal Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA"},{"name":"Division of General Internal Medicine, Montefiore Medical Center &amp; Albert Einstein College of Medicine, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Becker","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"},{"name":"National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA"},{"name":"Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA"},{"name":"General Internal Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA"},{"name":"Pain Research, Informatics, Multimorbidities &amp; Education Center of Innovation, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Ahmad FB Cisewski JA Rossen LM Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. Published 2022. Accessed December 11 2022. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.18543"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6911a4"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6935a1"},{"key":"e_1_3_2_6_2","unstructured":"Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2019 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. Published September 2020. Accessed April 2 2025. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt29393\/2019NSDUHFFRPDFWHTML\/2019NSDUHFFR090120.htm"},{"key":"e_1_3_2_7_2","unstructured":"Centers for Disease Control and Prevention. United States dispensing rate maps. Centers for Disease Control and Prevention U.S. Department of Health and Human Services. Published December 11 2023. Accessed March 28 2024. https:\/\/www.cdc.gov\/drugoverdose\/rxrate-maps\/index.html#print"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-022-00480-4"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-022-01384-6"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108588"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.09.018"},{"key":"e_1_3_2_12_2","unstructured":"National Institute on Alcohol Abuse and Alcoholism. Drinking levels defined. Accessed December 11 2022. https:\/\/www.niaaa.nih.gov\/alcohol-health\/overview-alcohol-consumption\/moderate-binge-drinking"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0167-6296(02)00080-2"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.310"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109399"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108978"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.02.003"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0382"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2021.2019776"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2022.04.001"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108127"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000717"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221111843"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2021.2006374"}],"container-title":["Substance Use &amp; Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251348150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342251348150","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251348150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:51:31Z","timestamp":1777600291000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342251348150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,16]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/29767342251348150"],"URL":"https:\/\/doi.org\/10.1177\/29767342251348150","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,16]]}}}