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7 Most Common Risk Factors for Opioid Use Disorder

April 18, 2022

Table of Contents

In the United States, over 2.1 million individuals struggle with opioid use disorder.[1] This epidemic has ravaged communities, families, and individuals across the nation. Even though an opioid use disorder can affect anyone, certain risk factors make an individual particularly susceptible to developing dependence. 

The 7 most common risk factors for opioid use disorder are:

  • Method of consumption - The way opioids are taken
  • Genetic predisposition - Family history with substance abuse and your genes
  • Age - Age groups that are particularly susceptible to developing an opioid use disorder
  • Past habits - Previous substance abuse
  • Social factors - Where we live, our upbringing, life experiences, social network, and environmental factors
  • Psychological factors - Mental health disorders and issues that contribute to the development of opioid use disorders
  • Chronic pain conditions - Certain medical conditions that increase susceptibility to the development of and opioid use disorder

Let’s delve deeper into each of these 7 opioid use disorder risk factors to better understand what they are and what it means for you.  

Method of Consumption

In predicting the risk of developing an opioid use disorder (OUD), how fast and how often opioids reach the brain can be more important than how much a person consumes.[2] 

The method of opioid consumption is one of the main risk factors for prescription drug abuse. Individuals build up a tolerance to opioids with continued use.

As opioid tolerance increases, individuals may change their method of consumption to achieve stronger and faster effects. This is done by snorting, injecting, or smoking opioids, as opposed to taking them as originally prescribed. 

Unlike a swallowed tablet, snorted and injected opioids bypass the digestive system and enter directly into the bloodstream. Injections are especially risky as the effects are felt immediately and all at once. This increases the risk for abuse and overdose. 

Smoking is the fastest route to the brain. The effects are immediate, highly potent, and short-lived. When smoked, the euphoric effects of the opioid fade as quickly as they come on. Thus, smoking opioids tends to increase the frequency of use. 

Genetic Predispositions

Among the more prominent risk factors for opioid use disorder is a person’s genetic background and family history. However, the science of genetic predisposition in the context of OUD is not entirely clear yet. 

Nevertheless, a family history of substance abuse is common among individuals struggling with OUD. Genetic predispositions can be considered as an assessment tool when gauging an individual’s risk of developing an OUD. Studies suggest that 40 to 60 percent of a person’s vulnerability to addiction is determined by their genes.[3] 


A person’s age often plays a role in their vulnerability to misuse and abuse opioids. As of 2019, individuals between the ages of 25 to 34 years old were particularly vulnerable to opioid addiction and overdose.[4] 

Moreover, two in every three adults with OUD report first using opioids before the age of 25.[5] In fact, teenagers and young adults are more likely to try, use, misuse, and abuse opioids than any other age bracket. 

Past Habits

Opioid use disorder risk factors include an individual’s history with substance abuse. As previously mentioned, genetic predispositions can increase the likelihood of an individual developing a substance abuse disorder. 

Similarly, a history of substance use disorder indicates a higher susceptibility to future disordered use. Even though past habits in no way assure future misuse, they are often considered a risk factor.

Past addictions to certain substances can help predict a person’s susceptibility to similar substances. In the context of OUD, the National Institute of Health (NIH) reported that approximately 80 percent of people who misuse heroin first misused prescription opioids.[6] Prescription opioid use has a staggering likelihood of devolving into a heroin addiction, as evidenced by data.     

Social Factors

Social and environmental factors can heighten the risk of developing OUD. For example, if you live in an area where prescription and illicit opioids are easily accessible, you are at increased risk of exposure and potential use. 

Other environmental risk factors include the following circumstances: 

  • Growing up in a household that normalized drug and alcohol abuse
  • Belonging to a peer group that uses drugs or alcohol
  • Having easy access to addictive substances

Emotional trauma is also among the many risk factors for OUD. They may increase one’s susceptibility to opioid use include: 

  • Exposure to sexual, emotional, or physical abuse
  • Loss of a loved one or divorce

Psychological Factors

Mental health disorders and psychological issues can increase susceptibility to developing OUD. Physical pain is one of the most common symptoms of diagnosed mental health disorders. 

In some cases, opioids are prescribed to treat this symptom. Studies have found that adults with mood and anxiety disorders are more likely to be prescribed opioids and remain taking them long-term.[7][8] 

Some of the most common mental health disorders seen in Medication for Addiction Treatment (MAT) include[9]:

  • Anxiety and mood disorders
  • Schizophrenia
  • Bipolar disorder
  • Major depressive disorder
  • Conduct disorders
  • Post-traumatic stress disorder
  • Attention deficit hyperactivity disorder

Chronic Pain Conditions

Chronic pain conditions tend to be a high risk factor for OUD. Opioids have long been a legitimate medical treatment for moderate to severe pain. Some opioids are prescribed to treat acute pain like among postoperative patients, for example. These prescriptions are taken only as needed and only last for a short period. They are not long-term treatment plans. 

Historically, long-term opioid prescriptions were used to treat the pain and discomfort of advanced chronic illness. Opioids were typically prescribed to patients in active cancer treatment, palliative care, and end-of-life care

More recently, there has been a significant increase in opioid prescriptions to treat moderate, non-cancer chronic pain conditions, such as back pain or osteoarthritis. This was a concerning trend and one of the prominent risk factors for prescription drug abuse. 

There is a strong relationship between legitimate opioid prescriptions and reported misuse, dependence, and addiction. In fact, research indicates that approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.[10] Moreover, an estimated 3 to 19 percent of people who take prescription pain medications develop an addiction to them.[10]

Given these concerning statistics, it is critical that patients understand opioid use disorder risk factors and discuss them with their doctor.  

Treatments for OUD

Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component in treatment. 

While behavioral therapies address the psychology of opioid use disorder, MOUDs address many of the physical and neurological discomforts. For example, MOUDs provide relief from cravings, the painful symptoms of withdrawal and block the euphoric effects of opioids. 

To date, three medications are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder: methadone, buprenorphine, and naltrexone.[11] 

All brand-name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and Zubsolv.

Learn More About Bicycle Health

Reach out to Bicycle Health if you or someone you know is struggling with an opioid use disorder. We use Suboxone as a primary medication for dealing with opioid dependence. To learn more about the benefits and the effects of Suboxone, schedule a time to speak with one of our MAT professionals, or call us today at (844) 943-2514.

Photo by Towfiqu barbhuiya on Unsplash

Daisy Duddy

Daisy Duddy, BA is a medical writer at Bicycle Health and the Executive Assistant at Harvard Medical School's Center for Primary Care. A native New Yorker, Daisy moved to Boston as an undergraduate student at Northeastern University where she graduated with a Bachelor of Arts in Sociology. Prior to her current position at Harvard Medical School, Daisy worked for numerous healthcare institutions including Boston's Children's Hospital, Boston Pharmaceuticals, and ATI Physical Therapy.

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3. Bevilacqua L, Goldman D. Genes and addictions. Clin Pharmacol Ther. 2009;85(4):359-361. doi:10.1038/clpt.2009.6

4. Kaiser Family Foundation. Opioid overdose deaths by age group.,%22sort%22:%22asc%22%7D. Published 2021. Accessed October 1, 2021.

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7. Goesling J, Henry MJ, Moser SE, Rastogi M, Hassett AL, Clauw DJ, Brummett CM. Symptoms of depression are associated with opioid use regardless of pain severity and physical functioning among treatment-seeking patients with chronic pain. The Journal of Pain. 2015;16(9): 844-851.

8. Halbert BT, Davis RB, Wee CC. Disproportionate longer-term opioid use among U.S. adults with mood disorders. Pain. 2016;157(11):2452-2457. doi:10.1097/j.pain.0000000000000650

9. Co-occurring disorders and other health conditions. Substance Abuse and Mental Health Services Administration. Updated August 19, 2020. Accessed October 1, 2021. 

10. Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569-576. doi:10.1097/01.j.pain.0000460357.01998.f1

11. Medication-assisted treatment (MAT). Substance Abuse and Mental Health Services Administration. Updated 10/07/2021. Accessed October 1, 2021. 

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