Poorest Americans most likely to have used prescription opioids—and most users view opioids positively

September 12, 2018 by Bert Gambini, University at Buffalo
Credit: CC0 Public Domain

Among older Americans, the poorest are the most likely to have used prescription opioids, according to a University at Buffalo study providing new insights into unexplored contours of the opioid crisis.

The study also raises important questions about access to options for the disadvantaged in the current climate of the ."The poor had about double the rate of use compared to wealthier groups," says Hanna Grol-Prokopczyk, an assistant professor in UB's sociology department and the study's author. "The poor are the ones who have been disproportionately relying on these medications—and it's not always easy for them to switch to other ways of dealing with ."

Grol-Prokopczyk, an expert in chronic , says the poor are less healthy than the general population and experience more pain, but her findings, which focused on prescribed use, not misuse, of opioids, indicate that even for the same , the poor were more likely to be using .

Little research on opioid use has focused specifically on older adults, despite their relatively high rates of opioid use and chronic pain. Some studies, without explanation, exclude adults over 65 altogether.

"Identifying the groups most affected by opioids is important because there are long-term risks from opioids even when used exactly as prescribed," she says. "These include increased risk of depression; suppressed immune function; and increased risk of death from causes other than overdose, such as cardiovascular and respiratory events. Policies and practices should make sure that disadvantaged groups receive information about the risks of opioids and have access to alternate pain treatments."

The results, which appear in the Journal of Gerontology: Social Sciences, are based on responses from 3,721 participants in the nationally representative Health and Retirement Study's 2005-06 Prescription Drug Study.

"These data are particularly useful because they were gathered during the peak period of opioid use in the U.S.," says Grol-Prokopczyk. "Participants also self-reported their pain level as low, moderate or severe, and gave their opinions of the prescription drugs they were using."

Most study participants indicated they were happy with opioid effectiveness. More than 80 percent felt the medication was important to their health and over 75 percent responded that it was the best medication for their pain management. Fewer than 12 percent reported unpleasant side effects.

Now that the therapeutic landscape has changed in the face of the opioid epidemic and opioid are harder to get, health care providers may instead recommend treatments that have limited insurance coverage or no coverage at all, such as physical therapy, cognitive behavioral therapy, hypnosis or acupuncture.

These often present challenges to poorer adults who might not be able to afford the alternatives or have the means to attend clinic visits that can span months or even years."Some pain researchers argue that the country is simultaneously experiencing an opioid crisis and a crisis of undertreated pain," says Grol-Prokopczyk.

"Effectively minimizing the risks of opioids while still addressing chronic pain will require understanding who is exposed to opioids, and ensuring that all groups can access alternate pain treatments."

Explore further: Poor and less educated suffer the most from chronic pain

More information: Hanna Grol-Prokopczyk, Use and Opinions of Prescription Opioids Among Older American Adults: Sociodemographic Predictors, The Journals of Gerontology: Series B (2018). DOI: 10.1093/geronb/gby093

Related Stories

Poor and less educated suffer the most from chronic pain

February 7, 2017
Poorer and less-educated older Americans are more like to suffer from chronic pain than those with greater wealth and more education, but the disparity between the two groups is much greater than previously thought, climbing ...

Coverage policies compared for back pain medications

June 25, 2018
(HealthDay)—There are opportunities for recalibrating the role of opioids in pain care, including expanding access to opioid alternatives through coverage and reimbursement policies, according to a study published online ...

College education linked to opioid misuse among baby boomers

March 22, 2018
The more educated a member of the baby boomer generation, the more likely they are to misuse prescription opioids, according to new research from the University at Buffalo.

New rules may constrain docs' ability to treat chronic pain

June 29, 2018
(HealthDay)—New laws and regulations designed to limit the use of prescription narcotics may further constrain doctors' ability to treat patients, according to an article published online May 30 in Medical Economics.

Physical therapy could lower need for opioids, but lack of money and time are hurdles

June 22, 2018
Physical therapists help people walk again after a stroke and recover after injury or surgery, but did you know they also prevent exposure to opioids? This is timely, given we are in a public health emergency related to an ...

Recommended for you

Probiotic use may reduce antibiotic prescriptions, researchers say

September 14, 2018
Use of probiotics is linked to reduced need for antibiotic treatment in infants and children, according to a review of studies that probed the benefits of probiotics, say researchers in the U.S., England and the Netherlands.

Sugar pills relieve pain for chronic pain patients

September 12, 2018
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology. And the pills will reduce their pain as effectively as any powerful drug on the market, according to ...

Recalled blood pressure drugs not linked to increased short term cancer risk

September 12, 2018
Products containing the withdrawn blood pressure drug valsartan are not associated with a markedly increased short term risk of cancer, finds an expedited analysis published by The BMJ today.

A new approach for finding Alzheimer's treatments

September 11, 2018
Considering what little progress has been made finding drugs to treat Alzheimer's disease, Maikel Rheinstädter decided to come at the problem from a totally different angle—perhaps the solution lay not with the peptide ...

One in four older adults prescribed a benzodiazepine goes on to risky long-term use

September 10, 2018
They may start as well-intentioned efforts to calm anxiety, improve sleep or ease depression. But prescriptions for sedatives known as benzodiazepines may lead to long-term use among one in four older adults who receive them, ...

Clinical need absent, unclear in nearly 30 percent of outpatient opioid prescriptions

September 10, 2018
Nearly 30 percent of outpatient opioid prescriptions in the United States lack documented clinical reasons that justify the use of these potent drugs, according to a national analysis of physician visit records conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.