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Within the past few decades, there has come to be an abundance of literature on prescription opioid misuse and how stress and socioeconomic status directly correlate with rates of misuse. The purpose of this literature review is to analyze the relationship between stress, socioeconomic status, and prescription opioid misuse. For the purposes of this literature review, the phrase “prescription opioid misuse” will refer to opioids prescribed to an individual, whether the individual has their own prescription or whether they obtain them illegally, and uses them somewhat habitually in ways other than for their directed use or in their prescribed dosage (National Institute on Drug Abuse 2020). After an overview of how these prescription opioids are obtained, opioids as a coping mechanism for dealing with stressors is discussed. General Strain Theory and Social Learning Theory are two primary theories that relate directly to stress that will be discussed in detail in this literature review. Next, the connection between low socioeconomic status and opioid misuse is examined, particularly how individuals with fewer supports, less access to healthcare, and more social disorganization have higher rates of misuse. The connection between high socioeconomic status and opioids misuse is examined, more specifically how those individuals have lower rates of misuse due to more supports, less stressors, and less social disorganization. The review concludes with a brief overview of the literature, suggestions for future research, and implications of the findings.