NCHS Data Brief ■ No. 369 ■ June 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.

Prevalence of Prescription Pain Medication Use Among 

Adults: United States, 2015–2018

Craig M. Hales, M.D., M.P.H., Crescent B. Martin, M.P.H., M.A., and Qiuping Gu, M.D., Ph.D.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey

● In 2015–2018, 10.7% of

U.S. adults aged 20 and over

used one or more prescription

pain medications (opioid or

nonopioid) in the past 30 days.

● In 2015–2018, 5.7% of

U.S. adults used one or more

prescription opioids.

● Prescription opioid

use was higher among

women than men, and use

increased with age.

● In 2015–2018, 5.0%

of adults used nonopioid 

prescription pain medications 

without prescription opioids 

in the past 30 days; use was 

lowest among non-Hispanic 

Asian adults. 

● From 2009–2010 through

2017–2018, no significant 

change in the use of 

prescription opioids was 

seen, but use of nonopioid 

prescription pain medications 

(without prescription opioids) 

increased.

Prescription pain medications are used to treat pain due to injury, surgery, 

and health conditions, such as arthritis and cancer. While opioids may be 

prescribed together with nonopioid pain medications, nonpharmacologic and 

nonopioid-containing pharmacologic therapies are preferred for management 

of chronic pain, where appropriate (1). This report shows the percentage 

of U.S. adults who, in the past 30 days, used one or more prescription 

pain medications, used prescription opioid medications, or used nonopioid 

prescription pain medications (without prescription opioids) in 2015–2018.

What percentage of U.S. adults used one or more 

prescription pain medications in the past 30 days in 

2015–2018, and did use differ by age and sex?

In 2015–2018, 10.7% of U.S. adults used one or more prescription pain 

medications in the past 30 days (Figure 1). Use increased with age, from 5.4% 

10.7

5.4

15.1

8.7

4.1

11.0

12.1

1

14.2

1

17.6

12.7 1

12.6

1

6.6

0

5

10

15

20

Women Men2 2 Total2

Figure 1. Use of prescription pain medications in the past 30 days among adults aged 20 and 

over, by sex and age: United States, 2015–2018

1

Significantly different from men.

2

Significantly increasing trend with age.

NOTE: Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db369-tables-508.pdf#1.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018. Percent

20 and over 20–39 40–59 60 and over
NCHS Data Brief ■ No. 369 ■ June 2020

■  2  ■

among adults aged 20–39 to 12.7% for those aged 40–59 to 15.1% for those aged 60 and over. 

Prescription pain medication use was higher among women (12.6%) compared with men (8.7%) 

overall and in all age groups. Prescription pain medication use increased with age among both 

men and women.

Did prescription pain medication use in the past 30 days differ by sex and 

race and Hispanic origin in 2015–2018?

Among all adults, prescription pain medication use was lowest among non-Hispanic Asian adults 

(4.5%) (Figure 2). Use was higher among non-Hispanic white (11.6%) than Hispanic (8.5%) 

adults, but use among both groups did not differ significantly from non-Hispanic black adults 

(10.1%). A similar pattern of race and Hispanic-origin differences was observed among men 

and women.

Prescription pain medication use was higher among women than among men for non-Hispanic 

white (13.7% compared with 9.4%), non-Hispanic black (12.2% compared with 7.4%), and 

Hispanic (10.2% compared with 6.8%) adults.

Figure 2. Use of prescription pain medications in the past 30 days among adults aged 20 and over, by sex and race and 

Hispanic origin: United States, 2015–2018

1

Significantly different from men of same race and Hispanic origin.

2

Significantly different from non-Hispanic white adults.

3

Significantly different from all other race and Hispanic-origin groups.

NOTE: Access data table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db369-tables-508.pdf#2.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018. Percent

0

5

10

11.6

10.1

3

4.5 3

4.0

3

4.9

1,210.2

1

12.2

1

13.7

2

6.8

7.4

9.4

2

8.5

15

Non-Hispanic white Non-Hispanic black Non-Hispanic Asian Hispanic

Total Men Women
NCHS Data Brief ■ No. 369 ■ June 2020

■  3  ■

What percentage of U.S. adults used one or more prescription opioid pain 

medications in the past 30 days in 2015–2018, and did use differ by sex, 

age, and race and Hispanic origin?

In 2015–2018, 5.7% of U.S. adults used one or more prescription opioids in the past 30 days 

(Figure 3). Use among women (6.4%) was higher than among men (4.9%), and use increased 

with age, from 2.8% among adults aged 20–39 to 6.6% for those aged 40–59 to 8.2% for those 

aged 60 and over. Use among non-Hispanic Asian adults (1.4%) was lowest among all race and 

Hispanic-origin groups. Use of prescription opioids was lower among Hispanic adults (3.4%) 

compared with non-Hispanic white adults (6.4%) and non-Hispanic black adults (5.2%).

Figure 3. Use of prescription opioids in the past 30 days among adults aged 20 and over, by sex, age, and race and 

Hispanic origin: United States, 2015–2018

1

Significantly different from men. 

2

Significantly increasing trend with age. 

3

Significantly different from all other race and Hispanic-origin groups.

4

Significantly different from non-Hispanic white and non-Hispanic black adults.

NOTES: Prescription opioid use was defined as using one or more prescription opioids with or without other nonopioid prescription pain medications. Access data 

table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db369-tables-508.pdf#3.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018.

Percent

0 2 4 6 8

5.7

4.9

1

6.4

2 6.6

3

1.4

4

3.4

2.8

8.2

6.4

5.2

10

Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

60 and over

40–59

20–39

Women

Men

Total
NCHS Data Brief ■ No. 369 ■ June 2020

■  4  ■

What percentage of U.S. adults used one or more nonopioid prescription 

pain medications without prescription opioids in the past 30 days in 

2015–2018, and did use differ by sex, age, and race and Hispanic origin?

In 2015–2018, 5.0% of U.S. adults used one or more nonopioid prescription pain medications 

without prescription opioids in the past 30 days (Figure 4). Use was higher among women 

(6.2%) than among men (3.8%), and use increased with age, from 2.6% among adults aged 

20–39 to 6.0% for those aged 40–59 to 7.0% for those aged 60 and over. Use was lowest among 

non-Hispanic Asian adults (3.0%) compared with all other race and Hispanic-origin groups. Use 

among non-Hispanic white (5.2%), non-Hispanic black (4.8%), and Hispanic (5.0%) adults did 

not differ.

Figure 4. Use of nonopioid prescription pain medications without prescription opioids in the past 30 days among adults 

aged 20 and over, by sex, age, and race and Hispanic origin: United States, 2015–2018

1

Significantly different from men. 

2

Significantly increasing trend with age. 

3

Significantly different from all other race and Hispanic-origin groups.

NOTES: Use of nonopioid prescription pain medications (without prescription opioids) was defined as using one or more nonopioid prescription pain medications 

without any use of prescription opioids. Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db369-tables-508.pdf#4.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018.

Percent

0 2 4 6 8 10

Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

60 and over

40–59

20–39

Women

Men

Total 5.0

3.8

1

6.2

2 6.0

3

3.0

5.0

2.6

7.0

5.2

4.8
NCHS Data Brief ■ No. 369 ■ June 2020

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What are the trends in the use of one or more prescription opioids and 

nonopioid prescription pain medications (without prescription opioids) 

among adults?

Between 2009–2010 and 2017–2018, no significant trend in the use of prescription opioids was 

observed; however, an increasing trend in the use of nonopioid prescription pain medications 

without prescription opioids was seen, from 4.3% in 2009–2010 to 5.7% in 2017–2018 (Figure 5). 

Between 2015–2016 and 2017–2018, use of prescription opioids remained the same (5.7%), but 

use of nonopioid prescription pain medications (without prescription opioids) increased from 

4.4% to 5.7%.

Figure 5. Use of prescription opioids and nonopioid prescription pain medications (without prescription opioids) in the past 

30 days among adults aged 20 and over: United States, 2009–2010 through 2017–2018

1

Significant linear trend.

2

Significant difference between 2015–2016 and 2017–2018.

NOTES: Prescription opioid use was defined as using one or more prescription opioids with or without nonopioid prescription pain medications. Use of nonopioid 

prescription pain medications (without prescription opioids) was defined as using one or more nonopioid prescription pain medications without any use of 

prescription opioids. Access data table for Figure 5 at: https://www.cdc.gov/nchs/data/databriefs/db369-tables-508.pdf#5.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2009–2018. Percent

0

4

5

6

7

8

2013–2014 2015–2016 2017–2018

Survey years

2009–2010 2011–2012

Nonopioid1,2

Opioid
NCHS Data Brief ■ No. 369 ■ June 2020

■ 6  ■

Summary

In 2015–2018, 10.7% of U.S. adults used one or more prescription pain medications in the past 

30 days. Prescription pain medication use was higher among women than men overall and within 

each age category. Use increased with age overall and among both men and women. Prescription 

pain medication use was lowest among non-Hispanic Asian adults, and use among Hispanic 

adults was lower than among non-Hispanic white adults. This same pattern of prescription pain 

medication use was observed in both men and women. 

Additionally, this report estimated the percentage of adults who used one or more opioid 

prescription pain medications (with or without use of nonopioid prescription pain medications) 

and the percentage who used one or more nonopioid prescription pain medications (without 

prescription opioids). In 2015–2018, 5.7% of U.S. adults used prescription opioids, and 5.0% 

used nonopioid prescription pain medications (without prescription opioids) in the past 30 days. 

Use of one or more prescription opioids and use of nonopioid prescription pain medications 

(without prescription opioids) was higher among women than men and increased with age; use 

was lowest among non-Hispanic Asian adults. Use of one or more prescription opioids among 

Hispanic adults was lower than among non-Hispanic white adults.

From 2009–2010 through 2017–2018, no significant increase in the use of prescription opioids 

was seen, but the use of nonopioid prescription pain medications (without prescription opioids) 

increased. 

Definitions

Prescription pain medication use: Participants were asked if they had taken a prescription 

medication in the past 30 days. Those who answered “yes” were asked to show the interviewer 

the medication containers of all prescription medications (2). For each drug reported, the 

interviewer recorded the product’s complete name from the container, if available. Prescription 

medications were classified based on the therapeutic classification scheme of Cerner Multum’s 

Lexicon (3). Prescription pain medication use was defined as using one or more prescription 

opioids or nonopioid pain medications or any medication classified as “analgesics–unspecified.”

Prescription opioids: Prescription opioids were identified using the Multum drug category codes 

60 (narcotic analgesics) and 191 (narcotic analgesic combinations). Medications containing 

buprenorphine, which are primarily used to treat opioid addiction, and opioid combinations 

formulated for treatment of upper respiratory infections were excluded. Prescription opioid 

use was defined as using one or more prescription opioids with or without other nonopioid 

prescription pain medications.

Nonopioid prescription pain medications (without prescription opioids): Nonopioid 

prescription pain medications were identified using the Multum drug category codes 63 

(analgesic combinations), 193 (antimigraine agents), 278 (COX-2 inhibitors), 61 (nonsteroidal 

anti-inflammatory agents), and 62 (salicylates). Medications containing aspirin as a single 

ingredient are typically used for cardiovascular disease prevention and were excluded. Certain 

antidepressants and anticonvulsants may also be used for some types of pain, but were excluded 

because of their broader indications. Use of nonopioid prescription pain medications (without 

prescription opioids) was defined as using one or more nonopioid prescription pain medications 

without any use of prescription opioids.
NCHS Data Brief ■ No. 369 ■ June 2020

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Data source and methods

The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional survey 

designed to provide nationally representative estimates of the noninstitutionalized population 

of the United States and is conducted by the National Center for Health Statistics (4). The 

survey consists of home interviews followed by standardized physical examinations in mobile 

examination centers. NHANES samples are selected through a complex, multistage probability 

design, and interview sample weights—which account for the differential probabilities of 

selection, nonresponse, and noncoverage—are incorporated into the estimation process. Standard 

errors were estimated by Taylor series linearization, which accounts for the design features of 

the survey. Pair-wise differences in the prevalence of prescription drug use were tested using a 

univariate t statistic. Trends were evaluated using logistic regression, with the survey cycle as a 

continuous independent variable. All differences reported are statistically significant at p < 0.05 

unless otherwise indicated. Data management and statistical analyses were conducted using 

R version 3.5.2 (R Foundation for Statistical Computing, Vienna, Austria), including the R 

survey package (5), SAS System for Windows version 9.4 (SAS Institute, Inc., Cary, N.C.), and 

SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.).

About the authors

Craig M. Hales, Crescent B. Martin, and Qiuping Gu are with the National Center for Health 

Statistics, Division of Health and Nutrition Examination Surveys. 

References

1. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic 

pain—United States, 2016. MMWR Recomm Rep 65(1):1–49. 2016.

2. National Center for Health Statistics. National Health and Nutrition Examination Survey 

2017–2018 data documentation, codebook, and frequencies: Prescription medications. Available 

from: https://wwwn.cdc.gov/Nchs/Nhanes/2017-2018/RXQ_RX_J.htm. 

3. National Center for Health Statistics. National Health and Nutrition Examination Survey 

1988–2018 data documentation, codebook, and frequencies: Prescription medications—Drug 

information. Available from: https://wwwn.cdc.gov/Nchs/Nhanes/1999-2000/RXQ_DRUG.htm.

4. National Center for Health Statistics. National Health and Nutrition Examination Survey: 

Questionnaires, datasets, and related documentation. Available from: https://wwwn.cdc.gov/nchs/

nhanes/Default.aspx.

5. Lumley T. Survey: Analysis of complex survey samples. R package version 3.35–1. 2019.
NCHS Data Brief ■ No. 369 ■ June 2020

Keywords: analgesic • drug • opioid • NHANES Suggested citation

Hales CM, Martin CB, Gu Q. Prevalence 

of prescription pain medication use among 

adults: United States, 2015–2018. NCHS 

Data Brief, no 369. Hyattsville, MD: 

National Center for Health Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Ryne Paulose-Ram, M.A., Ph.D., Acting 

Director

Lara J. Akinbami, M.D., Acting Associate 

Director for Science

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