MPOS 2019 Results

Non prescription opioids vs Heroin

The Maryland Public Opinion Survey (MPOS) is an ongoing annual survey by BHRT to evaluate prescription and non-prescription opioid misuse in Maryland.  This survey tracks changes in patterns of use, attitudes, and source of opioid misuse at the jurisdiction level in order to better inform strategies to mitigate the opioid epidemic. 

The below charts represent Maryland as a whole by default. Please select from the filter below to see data at the jurisdiction level.

How Prevalent is Use?

Overall prescription opioid misuse is much more common than heroin use over our sample's lifetime. Almost one quarter of respondents admitted to using prescription opioids outside of their intended purpose. Looking at the jurisdiction level of use, there does not seem to be a geographic trend for use of prescription opioids or heroin. The data also does not suggest any significant prevalence difference between rural and suburban areas.

Patterns of Use

The following graphs are based off of respondents who admitted to use non prescription opioids or heroin. Percentages represent from their retrospective populations, not overall population. 

The above charts show self reported reasons for using non prescription opioids and heroin.  In these charts we can see a distinct difference in motivation. Non prescription opioid misuse seems to be primarily motivated by physical pain, whereas heroin use was more related to addiction or getting high. 

In the above chart, we can see a breakdown of when the substance was first misused by age. Interestly, the age of initiation matched closely for all non-prescription opioid misusers and for those who specifically misused to get high except at age range 18-25 years old. 

In the below charts, we can see how these motivations differ amongst the age groups which may explain the above graph. We see that both the older and younger age group are most likely to misuse heroin due to addiction or getting high. However, we see a transformation of non-prescription opioid misuse between age groups. The older age group is almost completely misusing in order to manage pain, whereas the 18-25 age group is roughly equally motivated by pain management, getting high and experimentation. This suggests that all of these motivations need to be addressed when targeted a younger population for intervention.


Respondents perceived heroin as easier to access than prescription opioids. The doctor was perceived as a more difficult path to opioids compared to social access. This perhaps reflects a positive change in prescribing practices with regards to opioids.


Concern about prescription opioid misuse and heroin use seems relatively equal. However, while most respondents recognized a risk of harm for non-prescription opioid use, they were more divided onto the degree of risk inferred. Heroin use on the other hand was seen almost universally as a great risk for harm.

Below are the demographic breakdowns on risk of harms. The only demographic to have a significant amount of respondents believing the was no risk of harm for either substance was those with less than a high school education.