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Prescription opioid misuse remains a serious public health concern in the United States. While considerable research attention is paid to this issue, a relatively small number of studies focus specifically on older adult misuse, and even less stratify findings by race-ethnicity. The goal of this study was to identify prevalence and correlates of prescription opioid misuse among Black and White older adults (age 50+). Data used for this study ( n  = 21,488) come from a pooled sample (2016–2018) of the National Survey on Drug Use and Health. Stratified and pooled multivariable logistic regression models were estimated to determine which factors were associated with an increase/decrease in risk among Black and White older adults, adjusting for other relevant variables. Results showed that past-year prescription opioid misuse prevalence rates among older adults were equal for Blacks (2.5%) and Whites (2.5%), which was somewhat surprising given that prior studies generally show rates to be higher among Whites. Our analyses, stratified by race-ethnicity, also revealed notable Black–White variations in risk/protective factors. These findings show that Black and White older adults now account for a similar share of the prescription opioid misusing population and interventions aimed at preventing misuse among older adults should be targeted equally at both groups. Despite equal prevalence rates, Black and White older adults have unique risk profiles, suggesting that effective interventions will require tailoring. These findings are important in that they enhance the ability of opioid prescribers to identify high-risk older adult patients and can help make interventions more culturally relevant.

Prescription opioid misuse among Black and White older adults