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: Avoiding the risk of opioids

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

Avoiding the risk of opioids

June 1, 2018
Dear Mayo Clinic: If opioids are such a problem in our country, why are they used so often to treat pain? Aren't there other effective options for controlling pain that aren't as risky?

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

Rapid response inpatient education boosts use of needed blood-thinning drugs

November 16, 2018
A new study designed to reach hospitalized patients at risk shows that a "real-time" educational conversation, video or leaflet can lower the missed dose rates of drugs that can prevent potentially lethal blood clots in their ...

Want to cut down on your meds? Your pharmacist can help.

November 14, 2018
Pharmacists are pivotal in the process of deprescribing risky medications in seniors, leading many to stop taking unnecessary sleeping pills, anti-inflammatories and other drugs, a new Canadian study has found.

Immunity connects gut bacteria and aging

November 13, 2018
Over the years, researchers have learned that the different populations of bacteria that inhabit the gut have significant effects on body functions, including the immune system. The populations of gut bacteria are sometimes ...

Meditation and music may alter blood markers of cellular aging and Alzheimer's disease

November 13, 2018
A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer's ...

Health costs of ageism calculated at $63 billion annually, study finds

November 13, 2018
Ageism—a widespread form of prejudice that is directed at older persons—led to excess costs of $63 billion for a broad range of health conditions during one year in the United States, a new study by the Yale School of ...

Lifespan is increasing in people who live to 65

November 7, 2018
Stanford biologist Shripad Tuljapurkar had assumed humans were approaching the limit to their longevity – that's what previous research had suggested – but what he observed in 50 years of lifespan data was more optimistic ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Anonym518498
1 / 5 (1) Sep 19, 2018
snowflake generation

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.