Opioid Use Disorder 543
Associated Features Supporting Diagnosis
Opioid use disorder can be asso ciated with a history of drug-r elated crimes (e.g., posses-
sion or distribution of drugs, forgery, burglary, robbery, larc eny, receiving stolen goods).
Among health care professionals and individuals who have ready access to controlled
substances, there is often a different pattern of illegal activities involving problems with
state licensing boards, professional staffs of hospitals, or other administrative agencies.
Marital difficulties (including divorce), un employment, and irregular employment are of-
ten associated with opioid use diso rder at all socioeconomic levels.
Prevalence
The 12-month prevalence of opioid use disord er is approximately 0. 37% among adults age
18 years and older in the community population. This may be an underestimate because of
the large number of incarcerated individuals wi th opioid use disorders. Rates are higher in
males than in females (0.49% vs. 0.26%), with the male-to-female ratio typically being 1.5:1
for opioids other than heroin (i.e., available by prescription) and 3:1 for heroin. Female ad-
olescents may have a higher likelihood of developing opioid use disorders. The preva-
lence decreases with age, with the prevalence  highest (0.82%) among adults age 29 years or
younger, and decreasing to 0.09% among adul ts age 65 years and older. Among adults, the
prevalence of opioid use di sorder is lower among African Americans at 0.18% and over-
represented among Native Americans at 1.25%. It is close to average among whites (0.38%),
Asian or Pacific Islanders (0.35%), and Hispanics (0.39%).