Prescription opioid use among women of reproductive age in the United States: NHANES, 2003–2018

Women are prescribed opioids more often than men. Prescription opioid use among women of reproductive age is a public health concern because opioid use during pregnancy is associated with decreased prenatal care and increased risk of adverse perinatal and maternal outcomes. Recent prevalence estimates and correlates of prescription opioid use and long-term use among women of reproductive age are limited. Using the 2003–2018 National Health and Nutrition Examination Survey (NHANES), we estimated the national prevalence, trend, and correlates of prescription opioid use, long-term use (≥ 90 days of use), and use of medications for opioid use disorder (MOUD) among women aged 15–44 (n = 13,558). Prescription opioid use within the last 30 days and prescription duration were collected through interviews and identified using prescription codes. Trend analysis was conducted using the National Cancer Institute Joinpoint Trend Analysis Software. The prevalence of prescription opioid use significantly decreased from 5.2% in 2003–2004 to 3.0% in 2017–2018 (p < .05). MOUD use increased significantly from 0.1% in 2005–2006 to 0.4% in 2011–2012. Long-term opioid use did not significantly change over time. Correlates of prescription opioid use and long-term use included ages 35–44, non-Hispanic White, public insurance, and women with poor or fair health status. As policy makers and clinicians strive to reduce the negative impacts of the opioid epidemic, they should consider the demographic groups most likely to use prescription opioids long-term. Additionally, reductions in opioid prescribing should be balanced with increased availability of nonopioid therapies and monitoring for opioid use disorder.