Disclosures: Brian Brady, BA:
Objective: Historically, non-white patients were prescribed less opioid medication than white patients. However, because of persistent differential access to non-opioid pain treatments, this direction of disparity in opioid prescribing may have reversed. This study compared social disadvantage and self-reported health in patients with chronic pain who are currently managed with versus without chronic opioid treatment.
Design: Cross-sectional analysis of a retrospective cohort defined from medical record data between 2000 and 2019. Setting : Single tertiary academic medical center. Participants : Adult patients followed for chronic musculoskeletal pain, sub-grouped by chronic adherent opioid usage versus no opioid usage.
Interventions: Not applicable.
Main Outcome Measures: The primary comparison was the prevalence difference of social disadvantage in patients using versus not using opioids, measured by living in a zip code within the worst national quartile of the Area Deprivation Index. Secondary outcomes included differences in self-reported health by opioid use (measured by Patient-Reported Outcomes Measurement Information System (PROMIS)), after controlling for age, sex, race, and social disadvantage.
Results: In 1,173 patients (356 chronic opioid users), compared to non-opioid patients, chronic opioid patients were more likely to live in a zip code within the most socially disadvantaged national quartile (34.9% [95%CI 29.9% to 39.9%] vs 24.9% [21.9% to 28.0%], p < .001). Opioid use was independently associated with clinically relevant worse PROMIS Depression (3.8 points [2.4 to 5.1]), Anxiety (3.0 [1.4to 4.5]), and Pain Interference (2.6 [1.7 to 3.5]) scores. Conclusions: Patients on chronic opioids were more likely to live in socially disadvantaged neighborhoods, and chronic opioid use was independently associated with worse behavioral health. Improving access to multidisciplinary, non-opioid treatments for chronic pain may be a key approach to successfully overcoming the opioid crisis.
Level of Evidence: Level III
To cite this abstract in AMA style:
Brady B, Bradley E, Calfee R, Klesges L, Colditz G, Cheng AL, Prather H. Opioid Use and Social Disadvantage in Patients with Chronic Musculoskeletal Pain [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/opioid-use-and-social-disadvantage-in-patients-with-chronic-musculoskeletal-pain/. Accessed May 9, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/opioid-use-and-social-disadvantage-in-patients-with-chronic-musculoskeletal-pain/