Opioid Use Behaviors Among People With Disability in the United States: An Analysis of the National Survey on Drug Use and Health

Abstract

ObjectivePeople 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).MethodsThis 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.ResultsOf 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.ConclusionsPeople 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.

Marijuana use disorder among adults with functional disabilities—A US population‐based cross‐sectional study

“…6 In addition, the study also revealed this association varied by disability type and number of disabling limitations. 6 Due to the reciprocal nature between substance use and disability, it is also worth noting that substance use, especially substance use disorder, may further contribute to the worsening of disability status and symptoms. 7 Despite the requirement for a physician's authorization before the sale of medical marijuana to an individual in any cannabis dispensary, marijuana is one of the most common and accessible substances in the United States; for example, as of August 1, 2022, 37 states and the District of Columbia have medical marijuana laws.…”

“…Gimm et al found that the prevalence of past‐month marijuana use had increased significantly among both PWD and PWoD between 2015 and 2019 20 . However, Hong et al found a decreasing trend in prescription opioid use in both populations over the same period 6 . These diverging trends suggest that some adults may be substituting medical marijuana as an alternative to opioids and other illicit drugs after the marijuana legalization movement in the nation 24 .…”

“…20 However, Hong et al found a decreasing trend in prescription opioid use in both populations over the same period. 6 These diverging trends suggest that some adults may be substituting medical marijuana as an alternative to opioids and other illicit drugs after the marijuana legalization movement in the nation. 24 The rising trend in marijuana use disorder among PWD in this period from our study echoed previous studies.…”

“…Studies also suggest that discriminations against PWD (e.g., healthcare providers' implicit disability attitudes), persistent health disparities (e.g., more frequent chronic pain or major depressive episodes [MDEs]), and healthcare disparities (e.g., barriers to accessing formal medical treatments) may be associated with increased risk for substance use and substance use disorder among PWD 5 . A recent population‐based study using National Survey on Drug Use and Health (NSDUH) data showed that PWD were more likely to report opioid use, misuse, and disorder than PWoD 6 . In addition, the study also revealed this association varied by disability type and number of disabling limitations 6 .…”

“…5 A recent population-based study using National Survey on Drug Use and Health (NSDUH) data showed that PWD were more likely to report opioid use, misuse, and disorder than PWoD. 6 In addition, the study also revealed this association varied by disability type and number of disabling limitations. 6 Due to the reciprocal nature between substance use and disability, it is also worth noting that substance use, especially substance use disorder, may further contribute to the worsening of disability status and symptoms.…”