Women With Disabilities At Increased Risk for Prescription Opioid Misuse

A study published in the Journal of Women’s Health found that women and girls of reproductive age who had a disability were at increased risk for prescription opioid misuse.

Investigators from George Mason University in the United States sourced data for this study from the National Survey on Drug Use and Health (NSDUH) collected between 2015 and 2019. Risk for misuse of prescription opioids among nonpregnant women or girls aged 15 to 44 years (N=93,679) was evaluated on the basis of disability status.

The proportion of the study cohort with disabilities was 16.5%. The most common disabilities were cognitive disability (10.4%), daily living activities disability (6.84%), and difficulty with errands (5.18%).

Nearly half of those with a disability reported past-year prescription opioid use (48.0%; P ≤.05) which was significantly higher than women without a disability (32.3%; P ≤.05). Similarly, more women with a disability reported misuse of prescription opioids compared with nondisabled women (10.4% vs 4.2%), respectively.

Stratified by disability, the highest past-year opioid use was reported by women with difficulty dressing (68.4%) and difficulty walking (67.4%) and highest prescription opioid misuse by women with difficulty dressing (14.4%) and cognitive disability (12.0%).

Any opioid use was associated with any disability (adjusted odds ratio [aOR], 1.59), daily living activities disability (aOR, 1.83), cognitive disability (aOR, 1.48), and sensory disability (aOR, 1.34). Similarly, all 4 groups were also associated with opioid prescription use (aOR range, 1.32-1.81) and prescription opioid misuse (aOR, 1.43-2.13).

Nondisability predictors for any opioid use included fair or poor (odds ratio [OR], 2.42) and good (OR, 1.50) medical determinants of health compared with excellent status, illicit drug use (OR, 1.86), tobacco use (OR, 1.41), and alcohol use (OR, 1.20). Health status, tobacco use, and alcohol use were also predictors for opioid prescription use (OR range, 1.26-2.47) and opioid misuse (OR range, 1.34-2.37). Additional predictors for opioid misuse included being 15 to 17 years of age compared with being 26 to 44 years of age (OR, 1.32), living in a metropolitan area (OR, 1.20), and living in a household with 1 or 2 others compared with 5 or more (OR, 1.20).

Women with disabilities were most likely to have any use of hydrocodone (29.3%), oxycodone (17.3%), other opioids (14.1%), and tramadol (13.3%) and to misuse hydrocodone (5.87%) and oxycodone (3.95%).

The reported source of opioids most recently misused among those with disabilities was friends or relatives (55.0%), the medical system (36.4%), dealer or stranger (5.15%), and other source (3.47%).

The top 3 motivators for the most recent misuse among women with disabilities that differed from those without disabilities were to get high (22.1% vs 19.0%), for emotions (21.2% vs 11.8%), and sleep (20.8% vs 16.4%), respectively.

The results of this study may not be generalizable for institutionalized women with disabilities.

Study authors concluded, “The use of opioids among adults with disabilities in the United States is a mounting public health concern as this vulnerable population is at increased risk of frequent prescription opioid exposure due to chronic health conditions, and such prolonged exposure notably amplifies the risk for opioid-related disorders, including opioid misuse and opioid overdose.”