1
|
Adams RS, Corrigan JD, Ritter GA, Pringle ZA, Zolotusky G, Blayney R, Reif S. Association of Disability Status and Type With Binge Drinking and Prescription Opioid Misuse Among Adults From a 3-State Sample. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:453-465. [PMID: 38509844 DOI: 10.1177/29767342241236027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Research examining at-risk substance use by disability status is limited, with little investigation into differences by disability type. We investigated binge drinking and prescription opioid misuse among adults with and without disabilities, and by type of disability, to inform need for assessment and intervention within these populations. METHODS Secondary analyses of adults who completed the disability, alcohol, and prescription opioid misuse items in the 2018 Ohio, Florida, or Nebraska Behavioral Risk Factor Surveillance System surveys (n = 28 341), the only states that included prescription opioid misuse in 2018. Self-reported disability status (yes/no) relied on 6 standardized questions assessing difficulties with: vision, hearing, mobility, cognition, self-care, and independent living (dichotomous, nonmutually exclusive, for each disability). Logistic regression models estimated the association of disability status and type with (1) past 30-day binge drinking and (2) past-year prescription opioid misuse. Additional models were restricted to separate subsamples of adults who: (a) currently drink, (b) received a past-year prescription opioid, and (c) did not receive a past-year prescription opioid. RESULTS One-third reported at least one disability, with mobility (19.5%), cognitive (11.5%), and hearing (10.2%) disability being the most common. Disability status was associated with lower odds of binge drinking (adjusted odds ratio [AOR] = 0.74, 95% confidence interval [CI] 0.68-0.80, P ≤ .01). However, among adults who currently drink, people with disabilities had higher odds of binge drinking (AOR = 1.11, 95% CI 1.01-1.22, P ≤ .05]. Disability was associated with higher odds of past-year prescription opioid misuse (AOR = 2.51, 95% CI 2.17-2.91, P ≤ .01). CONCLUSIONS Adults with disabilities had higher odds of prescription opioid misuse, and among adults who currently drink, higher odds for binge drinking were observed. The magnitude of the association between disability status and prescription opioid misuse was particularly concerning. Providers should be trained to screen and treat for substance use problems for people with disabilities.
Collapse
Affiliation(s)
- Rachel Sayko Adams
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Grant A Ritter
- Schneider Institutes for Health Policy and Research, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Zoe A Pringle
- The Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Galina Zolotusky
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Rachel Blayney
- Ohio Department of Health, Violence and Injury Epidemiology and Surveillance Section, Columbus, OH, USA
| | - Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| |
Collapse
|
2
|
Hoffman KL, Milazzo F, Williams NT, Samples H, Olfson M, Diaz I, Doan L, Cerda M, Crystal S, Rudolph KE. Independent and joint contributions of physical disability and chronic pain to incident opioid use disorder and opioid overdose among Medicaid patients. Psychol Med 2024; 54:1419-1430. [PMID: 37974483 PMCID: PMC10994776 DOI: 10.1017/s003329172300332x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND Chronic pain has been extensively explored as a risk factor for opioid misuse, resulting in increased focus on opioid prescribing practices for individuals with such conditions. Physical disability sometimes co-occurs with chronic pain but may also represent an independent risk factor for opioid misuse. However, previous research has not disentangled whether disability contributes to risk independent of chronic pain. METHODS Here, we estimate the independent and joint adjusted associations between having a physical disability and co-occurring chronic pain condition at time of Medicaid enrollment on subsequent 18-month risk of incident opioid use disorder (OUD) and non-fatal, unintentional opioid overdose among non-elderly, adult Medicaid beneficiaries (2016-2019). RESULTS We find robust evidence that having a physical disability approximately doubles the risk of incident OUD or opioid overdose, and physical disability co-occurring with chronic pain increases the risks approximately sixfold as compared to having neither chronic pain nor disability. In absolute numbers, those with neither a physical disability nor chronic pain condition have a 1.8% adjusted risk of incident OUD over 18 months of follow-up, those with physical disability alone have an 2.9% incident risk, those with chronic pain alone have a 3.6% incident risk, and those with co-occurring physical disability and chronic pain have a 11.1% incident risk. CONCLUSIONS These findings suggest that those with a physical disability should receive increased attention from the medical and healthcare communities to reduce their risk of opioid misuse and attendant negative outcomes.
Collapse
Affiliation(s)
- Katherine L. Hoffman
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Floriana Milazzo
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Nicholas T. Williams
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | | | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Ivan Diaz
- New York University Grossman School of Medicine
| | - Lisa Doan
- New York University Grossman School of Medicine
| | | | | | - Kara E. Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| |
Collapse
|
3
|
Aram J, Dallal CM, Cosgrove C, Arria A, Liu H, Slopen N. The risk of drug overdose death among adults with select types of disabilities in the United States - A longitudinal study using nationally representative data. Prev Med 2024; 178:107799. [PMID: 38070712 DOI: 10.1016/j.ypmed.2023.107799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Disability is associated with increased risk of drug overdose mortality, but previous studies use coarse and inconsistent methods to identify adults with disabilities. This investigation makes use of the U.S. Department of Health and Human Services disability questions to estimate the risk of drug overdose death among U.S. adults using seven established disability categories. METHODS The longitudinal Mortality Disparities in American Communities study was used to determine disability status among a nationally representative sample of adults age ≥18 in 2008 (n = 3,324,000). Through linkage to the National Death Index, drug overdose deaths were identified through 2019. Adults in mutually-exclusive disability categories (hearing, vision, cognitive, mobility, complex activity, ≥2 limitations) were compared to adults with no reported disabilities using adjusted hazard ratios (aHRs) and controlling for demographic and socioeconomic covariates. RESULTS The risk of drug overdose death varied considerably by disability type, as adults in some disability categories displayed only marginally significant risk, while adults in other disability categories displayed substantially elevated risk. Compared to non-disabled adults, the risk of drug overdose death was highest among adults with ≥2 limitations (aHR = 3.0, 95% CI = 2.8-3.3), cognitive limitation (aHR = 2.6, 95% CI = 2.3-2.9), mobility limitation (aHR = 2.6, 95% CI = 2.3-2.9), complex activity limitation (aHR = 2.3, 95% CI = 1.8-2.9), hearing limitation (aHR = 1.6, 95% CI = 1.3-1.9), and vision limitation (aHR = 1.3, 95% CI = 1.0-1.7). CONCLUSIONS The examination of specific disability categories revealed unique associations that were not apparent in previous research. These findings can be used to focus overdose prevention efforts on the populations at greatest risk for drug-related mortality.
Collapse
Affiliation(s)
- Jonathan Aram
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, USA.
| | - Cher M Dallal
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, USA.
| | | | - Amelia Arria
- Department of Behavioral & Community Health, University of Maryland School of Public Health, USA.
| | - Hongjie Liu
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, USA.
| | | |
Collapse
|
4
|
Jammoul M, Jammoul D, Wang KK, Kobeissy F, Depalma RG. Traumatic Brain Injury and Opioids: Twin Plagues of the Twenty-First Century. Biol Psychiatry 2024; 95:6-14. [PMID: 37217015 DOI: 10.1016/j.biopsych.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/22/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
Traumatic brain injury (TBI) and opioid use disorder (OUD) comprise twin plagues causing considerable morbidity and mortality worldwide. As interactions between TBI and OUD are to our knowledge uncharted, we review the possible mechanisms by which TBI may stimulate the development of OUD and discuss the interaction or crosstalk between these two processes. Central nervous system damage due to TBI appears to drive adverse effects of subsequent OUD and opioid use/misuse affecting several molecular pathways. Pain, a neurological consequence of TBI, is a risk factor that increases the likelihood of opioid use/misuse after TBI. Other comorbidities including depression, anxiety, posttraumatic stress disorder, and sleep disturbances are also associated with deleterious outcomes. We examine the hypothesis that a TBI "first hit" induces a neuroinflammatory process involving microglial priming, which, on a second hit related to opioid exposure, exacerbates neuroinflammation, modifies synaptic plasticity, and spreads tau aggregates to promote neurodegeneration. As TBI also impairs myelin repair by oligodendrocytes, it may reduce or degrade white matter integrity in the reward circuit resulting in behavioral changes. Along with approaches focused on specific patient symptoms, understanding the CNS effects following TBI offers a promise of improved management for individuals with OUD.
Collapse
Affiliation(s)
- Maya Jammoul
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Dareen Jammoul
- Anesthesiology Department, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Kevin K Wang
- Center for Neurotrauma, MultiOmics & Biomarkers, Department of Neurobiology, Morehouse School of Medicine, Atlanta, Georgia; Department of Emergency Medicine, University of Florida, Gainesville, Florida.
| | - Firas Kobeissy
- Center for Neurotrauma, MultiOmics & Biomarkers, Department of Neurobiology, Morehouse School of Medicine, Atlanta, Georgia; Department of Emergency Medicine, University of Florida, Gainesville, Florida; Faculty of Medicine, Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
| | - Ralph G Depalma
- Office of Research and Development, Department of Veterans Affairs, Washington, DC; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| |
Collapse
|
5
|
El Ibrahimi S, Hendricks MA, Little K, Ritter GA, Flores D, Loy B, Wright D, Weiner SG. The association between community social vulnerability and prescription opioid availability with individual opioid overdose. Drug Alcohol Depend 2023; 252:110991. [PMID: 37862877 PMCID: PMC10754350 DOI: 10.1016/j.drugalcdep.2023.110991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND This study aims to assess the association of community social vulnerability and community prescription opioid availability with individual non-fatal or fatal opioid overdose. METHODS We identified patients 12 years of age or older from the Oregon All Payer Claims database (APCD) linked to other public health datasets. Community-level characteristics were captured in an exposure period (EP) (1/1/2018-12/31/2018) and included: census tract-level social vulnerability domains (socio-economic status, household composition, racial and ethnic minority status, and housing type and transportation), census tract-level prescriptions and community-level opioid use disorder (OUD) diagnoses per 100 capita binned into quartiles or quintiles. We employed Cox models to estimate the risk of fatal and non-fatal opioid overdoses events in the 12 months following the EP. MAIN FINDINGS We identified 1,548,252 individuals. Patients were mostly female (54%), White (61%), commercially insured (54%), and lived in metropolitan areas (81%). Of the total sample, 2485 (0.2%) experienced a non-fatal opioid overdose and 297 died of opioid overdose. There was higher hazard for non-fatal overdose in communities with greater OUD per 100 capita. We also found higher non-fatal and fatal hazards for opioid overdose among patients in communities with higher housing type and transportation-related vulnerability compared to the lowest quintile. Conversely, patients were at less risk of opioid overdose when living in communities with greater prevalence of the young or the elderly, the disabled, single parent families or low English proficiency. CONCLUSION These findings underscore the importance of the environmental context when considering public health policies to reduce opioid harms.
Collapse
Affiliation(s)
- Sanae El Ibrahimi
- Division of Research and Evaluation, Comagine Health, Portland, OR, United States; School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, United States.
| | - Michelle A Hendricks
- General Medical Sciences division, Washington University School of Medicine, St. Luis, MO, United States
| | - Kacey Little
- Division of Research and Evaluation, Comagine Health, Portland, OR, United States
| | - Grant A Ritter
- Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Diana Flores
- Division of Research and Evaluation, Comagine Health, Portland, OR, United States
| | - Bryan Loy
- Injury and Violence Prevention Program - Public Health Division - Oregon Health Authority, Portland, OR, United States
| | - Dagan Wright
- Injury and Violence Prevention Program - Public Health Division - Oregon Health Authority, Portland, OR, United States
| | - Scott G Weiner
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| |
Collapse
|
6
|
Aram J, Slopen N, Arria AM, Liu H, Dallal CM. Drug and alcohol use disorders among adults with select disabilities: The national survey on drug use and health. Disabil Health J 2023:101467. [PMID: 37088676 DOI: 10.1016/j.dhjo.2023.101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/13/2023] [Accepted: 03/18/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Deaths caused by drugs and alcohol have reached high levels in the US, and prior research shows a consistent association between disability status and substance misuse. OBJECTIVE Using national data, this study quantifies the association between disability status and drug and alcohol use disorders among US adults. METHODS The most recent pre-pandemic years (2018-2019) of the cross-sectional National Survey on Drug Use and Health (n = 83,439) were used to examine how the presence of any disability, and specific disabilities, were associated with past year drug and alcohol use disorders. Logistic regression was used to estimate adjusted odds ratios (aORs) controlling for potential sociodemographic confounders. RESULTS Adults with any disability had increased odds of drug (aOR = 2.7; 95% CI = 2.5-3.0), and alcohol use disorder (aOR = 1.8; 95% CI = 1.6-2.0), compared to adults without disability. Examining specific types of disabilities, adults with cognitive limitations only had increased odds of drug (aOR = 3.1; 95% CI = 2.6-3.6), and alcohol use disorders (aOR = 2.2; 95% CI = 1.9-2.5), compared to adults without disability. Smaller associations were observed between vision and complex activity limitations and drug use disorder. Adults with two or more types of limitations had increased odds of drug (aOR = 3.7; 95% CI = 3.3-4.3), and alcohol use disorders (aOR = 2.3; 95% CI = 2.0-2.6). CONCLUSIONS The presence of disability, especially cognitive limitation only, or two or more types of limitations, is associated with elevated odds of drug and alcohol use disorder among US adults. Additional research should examine the temporal relationship between and mechanisms linking disability and substance misuse.
Collapse
Affiliation(s)
- Jonathan Aram
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, University of Maryland College Park, MD 20742, USA.
| | - Natalie Slopen
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave. Boston, MA 02115, USA.
| | - Amelia M Arria
- Department of Behavioral & Community Health, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, University of Maryland College Park, MD 20742, USA.
| | - Hongjie Liu
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, University of Maryland College Park, MD 20742, USA.
| | - Cher M Dallal
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, University of Maryland College Park, MD 20742, USA.
| |
Collapse
|
7
|
Gimm G, Parekh T, Kitsantas P. Assessing the prevalence and risk factors of marijuana use in adults with disabilities. Addict Behav 2023; 138:107559. [PMID: 36459827 DOI: 10.1016/j.addbeh.2022.107559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Public support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. Given the growing prevalence and concerns about potential harms, a better understanding is needed of disparities in marijuana use among adults by disability status. METHODS Using 2015-2019 data from the National Survey on Drug Use and Health (NSDUH), we obtained a national sample of 195,130 working-age (18-64 year) adults. Descriptive and multivariable analyses were conducted to assess the prevalence and risk factors associated with marijuana use among adults by disability status and type. RESULTS We found the prevalence of marijuana use was higher among adults with disabilities (16.6% vs 10.9%) compared to those without disabilities, and this disparity widened from 2015 to 2019. Furthermore, the odds of marijuana use varied by disability type. Specifically, adults with vision disability only (OR 1.28; 95% CI 1.14-1.44), cognitive disability only (OR 1.24; 95% CI 1.13-1.35), and those with multiple disabilities (OR 1.22; 95% CI 1.11-1.34) had higher odds of marijuana use compared to adults without any disability. CONCLUSIONS Adults with disabilities have a higher prevalence of marijuana use compared to those without disabilities. Living in a state with legalized medical marijuana also increased the odds of marijuana use. These findings can help to inform policy and public health surveillance of marijuana use in the U.S. Further studies are needed to monitor the rising prevalence of marijuana use and examine how intensity of marijuana use affects health outcomes in adults with and without disabilities.
Collapse
Affiliation(s)
- Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, United States.
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, United States
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, United States
| |
Collapse
|
8
|
Thomas CP, Stewart MT, Ledingham E, Adams RS, Panas L, Reif S. Quality of Opioid Use Disorder Treatment for Persons With and Without Disabling Conditions. JAMA Netw Open 2023; 6:e232052. [PMID: 36884250 PMCID: PMC9996401 DOI: 10.1001/jamanetworkopen.2023.2052] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Adverse outcomes associated with opioid use disorder (OUD) are disproportionately high among people with disabilities (PWD) compared with those without disability. A gap remains in understanding the quality of OUD treatment for people with physical, sensory, cognitive, and developmental disabilities, specifically regarding medications for OUD (MOUD), a foundation of treatment. OBJECTIVE To examine the use and quality of OUD treatment in adults with diagnosed disabling conditions, compared with adults without these diagnoses. DESIGN, SETTING, AND PARTICIPANTS This case-control study used Washington State Medicaid data from 2016 to 2019 (for use) and 2017 to 2018 (for continuity). Data were obtained for outpatient, residential, and inpatient settings with Medicaid claims. Participants included Washington State full-benefit Medicaid enrollees aged 18 to 64 years, continuously eligible for 12 months, with OUD during the study years and not enrolled in Medicare. Data analysis was performed from January to September 2022. EXPOSURES Disability status, including physical (spinal cord injury or mobility impairment), sensory (visual or hearing impairments), developmental (intellectual or developmental disability or autism), and cognitive (traumatic brain injury) disabilities. MAIN OUTCOMES AND MEASURES The main outcomes were National Quality Forum-endorsed quality measures: (1) use of MOUD (buprenorphine, methadone, or naltrexone) during each study year and (2) 6-month continuity of treatment (for those taking MOUD). RESULTS A total of 84 728 Washington Medicaid enrollees had claims evidence of OUD, representing 159 591 person-years (84 762 person-years [53.1%] for female participants, 116 145 person-years [72.8%] for non-Hispanic White participants, and 100 970 person-years [63.3%] for participants aged 18-39 years); 15.5% of the population (24 743 person-years) had evidence of a physical, sensory, developmental, or cognitive disability. PWD were 40% less likely than those without a disability to receive any MOUD (adjusted odds ratio [AOR], 0.60; 95% CI, 0.58-0.61; P < .001). This was true for each disability type, with variations. Individuals with a developmental disability were least likely to use MOUD (AOR, 0.50; 95% CI, 0.46-0.55; P < .001). Of those using MOUD, PWD were 13% less likely than people without disability to continue MOUD for 6 months (adjusted OR, 0.87; 95% CI, 0.82-0.93; P < .001). CONCLUSIONS AND RELEVANCE In this case-control study of a Medicaid population, treatment differences were found between PWD and people without these disabilities; these differences cannot be explained clinically and highlight inequities in treatment. Policies and interventions to increase MOUD access are critical to reducing morbidity and mortality among PWD. Potential solutions include improved enforcement of the Americans with Disabilities Act, workforce best practice training, and addressing stigma, accessibility, and the need for accommodations to improve OUD treatment for PWD.
Collapse
Affiliation(s)
- Cindy Parks Thomas
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Maureen T. Stewart
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Emily Ledingham
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Rachel Sayko Adams
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, Colorado
| | - Lee Panas
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Sharon Reif
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| |
Collapse
|
9
|
Opioid Use Behaviors Among People With Disability in the United States: An Analysis of the National Survey on Drug Use and Health. J Addict Med 2023; 17:e27-e35. [PMID: 35861360 DOI: 10.1097/adm.0000000000001031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE People with disability (PWD) often experience chronic pain, and opioid is widely used prescription medication. However, population-based evidence of opioid use behaviors among PWD is lacking. This study examined the prevalence of opioid use behaviors by sociodemographic and health-related characteristics among PWD compared with people without disability (PWoD). METHODS This cross-sectional study used data from 2015-2019 National Survey on Drug Use and Health. Three types of opioid use behaviors (any use, misuse, and use disorder) were defined and compared by disability status. Five self-reported disability types were measured, including hearing, vision, cognitive, mobility, and complex activity limitations. Complex survey design-adjusted descriptive and logistic regression models were used for statistical analysis. RESULTS Of 201,376 respondents aged 18 years or older, 34.6% reported any opioid use, 4.2% opioid misuse, and 0.8% opioid use disorder. Compared with PWoD, PWD had higher prevalence of any opioid use (49.7% vs 30.7%), misuse (6.2% vs 3.7%), and use disorder (1.7% vs 0.8%). In adjusted analysis, PWD with mobility limitation (odds ratio [OR], 1.95; 95% confidence interval, 1.81-2.11) or multiple limitations (OR, 1.92; 95% CI, 1.83-2.02) were almost 2 times more likely to report any opioid use than PWoD. The likelihood of reporting any opioid use (ORs, 1.42-2.50), misuse (ORs, 1.24-2.41), and disorder (ORs, 1.38-2.54) increased as the number of limitations increased. CONCLUSIONS People with vision, cognitive, or multiple limitations had higher rates of opioid misuse and disorder than PWoD. Development of more inclusive opioid abuse prevention strategies for PWD is warranted.
Collapse
|
10
|
Chan KT, Marsack-Topolewski CN. The Association of Opioid Misuse and Suicidality among People with Disabilities. Subst Use Misuse 2022; 58:1-10. [PMID: 36476221 PMCID: PMC9792431 DOI: 10.1080/10826084.2022.2125271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background/Purpose: Past research has linked non-medical prescription opioid use (NMPOU) with suicide, though less focus has been placed among people with disabilities impacted by the opioid epidemic. This study examined the relationship of NMPOU and suicidality among people with and without disabilities while controlling for sociodemographic and other variables. Method: Using the 2019 National Survey on Drug Use and Health, weighted logistic regression analyses were conducted on a cross-sectional sample of 38,088 respondents 18 and older to examine the effect of opioid misuse and disability on serious thoughts of suicide, having a suicide plan, and making a suicide attempt. Results: Findings indicated opioid misuse was associated with 37% higher odds for having a suicide plan in the past year (OR = 1.37, p < .05). The main results indicated the people with disabilities had 30% higher odds for having a suicide plan (OR = 1.30, p < .05) and 73% higher odds for a suicide attempt in the past year (OR = 1.73, p < .001). Interaction analysis found that opioid misuse was associated with higher odds for having a suicide plan (OR = 1.89, p < .01), and having a suicide attempt among those with disabilities (OR = 2.57, p < .01). Conclusion: Results indicated that opioid misuse is a risk factor for suicide, and people with disabilities were at greater risk. Health workers can serve as a nexus point in effectively engaging at-risk people with disabilities in substance use and mental health prevention and recovery services.
Collapse
Affiliation(s)
- Keith T Chan
- Silberman School of Social Work, Hunter College, New York, New York, USA
| | | |
Collapse
|
11
|
Reif S, Karriker-Jaffe KJ, Valentine A, Patterson D, Mericle AA, Adams RS, Greenfield TK. Substance use and misuse patterns and disability status in the 2020 US National Alcohol Survey: A contributing role for chronic pain. Disabil Health J 2022; 15:101290. [DOI: 10.1016/j.dhjo.2022.101290] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/02/2021] [Accepted: 07/15/2021] [Indexed: 11/15/2022]
|
12
|
Akobirshoev I, McKee MM, Reif S, Adams RS, Li FS, Mitra M. Opioid Use Disorder-Related Emergency Department Visits Among Deaf or Hard of Hearing Adults in the United States. Disabil Health J 2022; 15:101291. [DOI: 10.1016/j.dhjo.2022.101291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 11/03/2022]
|