Nonmedical Use of Prescription Opioids: Use to Experience Subjective Effects Versus Other Nonmedical Use Among Adults in Ontario, Canada From 2020 to 2024.

Abstract

Objective: The opioid crisis remains an important public health concern, with nonmedical use of prescription opioids (NMUPO) playing a significant role. However, limited evidence exists on how adults engaging in NMUPO for subjective effects differ from those who use them for other nonmedical reasons. This study aims to identify and examine factors associated with engagement in NMUPO for subjective effects.

Method: Data were from the 2020 to 2024 CAMH Monitor study, a repeated cross-sectional survey of adults age 18 and older (N = 7,655). The surveys used a Qualtrics-based web survey to assess NMUPO, sociodemographic factors, substance use, and mental health. Data were analyzed using multivariate multinomial logistic regression.

Results: About 3% of adults engaged in NMUPO for subjective effects/to get high, and 15% of participants engaged in NMUPO for other nonmedical purposes during 2020 and 2024. These percentages remained stable over the years. The risk of NMUPO for subjective effects, compared with NMUPO for other purposes, was significantly higher among Asian people compared with their White counterparts (relative risk ratio [RRR] = 1.80, 95% CI [1.08, 3.01]) and among those with children (RRR = 2.53, 95% CI [1.64, 3.92]). Similarly, individuals with low household income, current other substance use, and psychological distress exhibited a higher risk of NMUPO, after adjusting for covariates.

Conclusions: Individuals who use prescription opioids nonmedically for subjective effects or other reasons differ by race/ethnicity, parental status, income, substance use, and level of psychological distress. These findings suggest the need for targeted prevention and intervention strategies to address the unique needs and behaviors of different user groups.