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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Reduce the proportion of prescription pain reliever misuse initiation in the past year — SU‑20 Data Methodology and Measurement

On this page:  About this objective  |  Methodology  |  History

About this objective

Data

Data Source:  National Survey on Drug Use and Health (NSDUH), SAMHSA

National baseline: 0.65 percent of persons aged 12 years and over reported prescription pain reliever misuse initiation in the past 12 months in 2021

National target: 0.45 percent

Numerator
Number of persons aged 12 years and over reporting prescription pain reliever misuse initiation in the past 12 months.
Denominator
Number of persons aged 12 years and over.
National target-setting method
Minimal statistical significance
National target-setting method details
Minimal statistical significance, assuming the same standard error for the target as for the baseline.
National target-setting method justification
Trend data are not available due to the NSDUH redesign. Data from 2021 cannot be compared or combined with data from previous years. The standard error was used to calculate a target based on minimal statistical significance, assuming the same standard error for the target as for the baseline. This method was used because it retains the original target setting method and was a statistically significant improvement from the baseline. The Workgroup Subject Matter Experts viewed this as an ambitious yet achievable target.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2021 National Survey on Drug Use and Health:

Numerator:
In the past 12 months, did you use [prescription pain reliever type] in any way a doctor did not direct you to use it? Please think about the first time you ever used [prescription pain reliever type] in a way a doctor did not direct you to use it. How old were you when you first used [prescription pain reliever type] in a way a doctor did not direct you to use it?
  • AGE __________
Did you first use [prescription pain reliever type] in a way a doctor did not direct you to use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
  1. CURRENT YEAR-1
  2. CURRENT YEAR
Did you first use [prescription pain reliever type] in a way a doctor did not direct you to use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
  1. CURRENT YEAR-2
  2. CURRENT YEAR-1
In what month in [YEAR] did you first use [prescription pain reliever type] in a way a doctor did not direct you to use it?
  1. January
  2. February
  3. March
  4. April
  5. May
  6. June
  7. July
  8. August
  9. September
  10. October
  11. November
  12. December

Methodology notes

Past year initiates include those who used that substance (misused in the case of prescription pain relievers) for the first time in the past year. Misuse of prescription pain relievers is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than told; or use in any other way not directed by a doctor. Prescription pain relievers do not include over-the-counter drugs.

History

Revision History
Revised. 

In 2024, the baseline was revised from 0.74% in 2017 to 0.65% in 2021. The target setting method, minimal statistical significance, remained the same; however, the target was revised from 0.62% to 0.45% using the 2021 data.
Trend issues
SAMHSA started multimode data collection (in-person and web-based collection) for the National Survey on Drug Use and Health (NSDUH) beginning in Quarter 4 (i.e., October to December) of 2020 due to COVID-19 pandemic. The 2021 NSDUH is based on both in-person and web interviews. Prior to 2020, NSDUH data are based on in-person data collection alone. The 2020 NSDUH included only 2 quarters (Quarters 1 and 4) of data collection unlike the four quarters of data collected in other years. Several analyses were conducted to investigate the impacts of these and related methodological issues on estimates for 2021. Using the outcomes of the comparability analyses, the following decisions were made regarding the 2021 NSDUH data. • Estimates from 2021 cannot be compared with those in 2019 or prior years because estimates from a multimode year are not comparable with estimates from a single-mode year. Estimates of change from 2019 or earlier to 2021 would probably be too greatly influenced by the mode effect. • Because of effects on estimates when some quarters of data are excluded or missing, 2020 estimates (based on two quarters of data) cannot be compared with those of any other year, including 2021. Using only 2 quarters of data may yield a different trend than use of 4 quarters of data. • NSDUH data from 2021 should not be combined or compared with any prior data.