Another possible consequence of a changing opioid market is that the sources from where persons with POUD obtain opioids used for non-medical reasons may have changed. Earlier cross-sectional studies have shown that the majority of persons who misuse prescription opioids obtain them for free from friends or family or receive them from a physician prescription (25–27). While persons with POUD are also most likely to obtain opioids from these two sources (27), they are also disproportionately likely to obtain prescription opioids via illicit means compared to non-medical users without POUD (13). Whether the relative importance of sources of opioids for non-medical reasons has changed over time for persons with POUD has not been previously reported.
