Study examines sex differences in prescription opioid use

A new University of Florida study finds that community-dwelling women are significantly more likely to report using prescription opioids than men. While sex differences at the national level have been examined previously, the UF study is one of the first to evaluate these differences at the community level. The findings appear in the journal Drug and Alcohol Dependence.

The UF study also found that prescription sedative use was the strongest risk factor for prescription opioid use, regardless of sex. This surprising finding is cause for concern, said lead author Dr. Mirsada Serdarevic, who conducted the study as part of her dissertation work in the Ph.D. program in epidemiology at the UF College of Public Health and Health Professions and UF College of Medicine. The pharmacodynamics of opioids and sedatives change when they are taken together, increasing the risk of overdose.

“When considering the prevention of non-medical prescription opioids, clinicians should avoid co-prescribing opioids and sedatives and be vigilant about the comorbidities that may be present among individuals with pain,” said Dr. Serdarevic, now an assistant member in the Center for Outcomes Research at JPS Health Network in Fort Worth, Texas.

The team evaluated responses from more than 9,000 north central Florida residents who are members of UF HealthStreet, a CTSA community engagement program. Members are interviewed by a community health worker about their health conditions, health concerns and history of substance use.

Researchers found the overall past 30-day rate of prescription opioid use to be 14%, double the rate reported by a recent Centers for Disease Control and Prevention study. Among male respondents, 33% reported lifetime but not past 30-day use of prescription opioids, with 12% reporting past 30-day use. Among women, 41% reported lifetime but not past-30 day prescription opioid use, with 15% reporting past 30-day use.

“These findings from a community-based study suggest that research among communities where opioid prescribing is common may provide better insight into risk factors than national studies alone,” Dr. Serdarevic said. “The findings further reiterate that sex differences in prescription opioid use have not been adequately assessed and should be considered in future prevention efforts.”

In addition to Dr. Serdarevic, the study team included her mentor, Dr. Linda B. Cottler, a dean’s professor of epidemiology and PHHP’s associate dean for research, Dr. Catherine Striley, a research associate professor of epidemiology, Dr. Kelly Gurka, an assistant professor of epidemiology, and Dr. Robert Leeman, an associate professor of health education and behavior in the UF College of Health and Human Performance.