A Descriptive Examination of Nonmedical Fentanyl Use in the United States: Characteristics of Use, Motives, and Consequences

• Author: Preston Hunt,Alison Looby,Tess M. Kilwein
• Date: 01 July 2018
• Published date: 01 July 2018
• DOI: 10.1177/0022042618765726
• Subject Matter: Articles

https://doi.org/10.1177/0022042618765726

Journal of Drug Issues

2018, Vol. 48(3) 409 –420

© The Author(s) 2018

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DOI: 10.1177/0022042618765726

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Article

A Descriptive Examination of

Nonmedical Fentanyl Use in the

United States: Characteristics of

Use, Motives, and Consequences

Tess M. Kilwein1, Preston Hunt1, and Alison Looby1

Abstract

Little is currently known about nonmedical fentanyl use (NFU; that is, use of illicit or

pharmaceutically produced fentanyl without a prescription or in ways other than prescribed)

despite increases in prevalence and consequences (e.g., overdose, fatality). Individuals with a

lifetime history of NFU (N = 122) in the United States completed an online survey assessing

demographics and factors related to use. Results revealed diversion of prescriptions, unintentional

use of illicit fentanyl, and high co-occurrence of mental illness and other illicit substance use

among users. Commonly reported motives reflected negative/positive reinforcement (e.g., to

relieve stress, to get high) and relieving pain/physical discomfort, regardless of frequency of

use. More severe consequences (e.g., increased tolerance, withdrawal) were reported among

high frequency users. This descriptive examination of NFU may aid in the identification of

individuals at-risk for use, promote an understanding of reasons for use, and guide prevention

and intervention developments.

Keywords

fentanyl, opioids, nonmedical prescription use, motives, consequences

The United States has seen a significant increase in the prevalence, diversion, and adverse conse-

quences associated with nonmedical opioid use, or the use of illicit opioids or prescription opioids

without a prescription or in ways other than prescribed (Substance Abuse and Mental Health

Services Administration [SAMSHA], 2016). Specifically, the age-adjusted death rate from only

2013 to 2014 has increased for heroin by 26%, for semi-synthetic opioids (e.g., oxycodone, hydro-

codone) by 9%, and for synthetic opioids other than methadone (e.g., buprenorphine, meperidine)

by 80% (Rudd, Aleshire, Zibbell, & Matthew Gladden, 2016). One extremely potent synthetic

opioid analgesic increasingly used for nonmedical purposes is fentanyl, which is estimated at 100

times stronger than morphine (Volpe et al., 2011). Since approximately 2013, the opioid epidemic

has been exacerbated by deaths involving both prescription and illicitly manufactured fentanyl

(Drug Enforcement Administration [DEA], 2015a; Gladden, Martinez, & Seth, 2016). In fact, the

rate of overdose deaths involving synthetic opioids (including prescription and illicit fentanyl)

1University of Wyoming, Laramie, USA

Corresponding Author:

Tess M. Kilwein, Department of Psychology, University of Wyoming, 1000 E. University Ave.,

Laramie, WY 82071, USA.

Email: tkilwein@uwyo.edu

765726JODXXX10.1177/0022042618765726Journal of Drug IssuesKilwein et al.

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