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

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.