The opioid crisis is a national public health emergency. Over 47,000 people in the U.S. died of opioid overdoses in 2017. Improving our knowledge about how people first come to misuse opioids can help to inform prevention and treatment interventions. This research brief shows that opioid misuse most often begins before age 25, most people obtain the opioids they misuse from friends and family rather than a health care provider, and experimenting and coping with life stressors are the most common motivations for starting opioid misuse