Opioid use among people with disabilities has declined, but rates of misuse remain constant, study finds

Young Rock Hong
Dr. Young Rock Hong

As awareness of the potential risks of prescribing opioids has increased, use of the narcotic pain medicine among people with disabilities has declined. Yet, the prevalence of prescription opioid misuse has remained the same in this population, according to a University of Florida study published in the Journal of Addiction Medicine.

The UF researchers also found that people with disabilities who had an opioid misuse or use disorder were more likely to have a use disorder related to another substance, such as tobacco, alcohol, cocaine or cannabis.

“We know chronic physical pain is one of the most frequently cited reasons for opioid misuse, and for those living with disabilities, using opioids could be a means to survive through both the physical and emotional pain resulting from their disability,” said the study’s lead investigator Young-Rock Hong, Ph.D., M.P.H., an assistant professor of health services research, management and policy in the UF College of Public Health and Health Professions and a member of the UF Health Cancer Center.

For the study, UF researchers analyzed data from the 2015-2019 National Survey on Drug Use and Health. Consistent with previous studies, they discovered that people with disabilities reported higher rates of opioid use, misuse and use disorder than people without disabilities. The UF team found that having disability increased the odds of opioid misuse and disorder by 31% to 54%.

During the study period, prescription opioid use among people with disabilities declined from 54% in 2015 to 45% in 2019; however, the prevalence of opioid misuse and disorder among people with disabilities remained the same at about 6% for misuse and 1.5% for disorder.

The UF team also examined associations with opioid use by disability type. They discovered that people with vision, cognitive or multiple limitations are particularly at risk for opioid misuse.

“We also found a ‘dose-response’ relationship between disability status and opioid misuse/disorder, which means that as the number of disabilities increases, the likelihood of having misuse/disorder also increases,” Hong said.

It is important to note that opioid misuse and disorder are complex and multifactorial problems, Hong said.

“Interventions should consider approaches to improve quality of life, such as alleviating mental stress and physical pain, and be designed to offer inclusive and accessible prevention and treatment services for those with disabilities,” he said.

In addition to Hong, the study team included Zhigang Xie, Ph.D., M.P.A., and Sandhya Yadav, Ph.D., M.P.A., D.D.S., recent graduates of the UF Ph.D. program in health services research; Rebecca Tanner, M.S., research coordinator; Catherine Striley, Ph.D., M.S.W., M.P.E., a UF associate professor of epidemiology; and Nicole M. Marlow, Ph.D., M.S.P.H., a UF research assistant professor of health services research, management and policy.