- Adults aged
Why this matters
- Among Medicare participants with a disability, having 3 co-occurring conditions of substance abuse, mental illness, and chronic pain syndrome was associated with a 23.4-fold increase in risk of opioid-related overdose death.
- Cohort study of 1,766,790 Medicare enrollees (age, 21-64 years) who qualified for disability.
- The opioid overdose rate was assessed.
- Funding: The National Institute on Drug Abuse, NIH.
- Medicare enrollees who qualified for disability represented:
- 14.9% (95% CI, 14.9%-15.0%) of all Medicare patients; and
- 80.8% (95% CI, 78.9%-82.7%) of opioid overdose deaths.
- Conditions associated with opioid overdose death were (P<.001 from: style="list-style-type:circle;">
- substance abuse:
- opioid use disorder (aOR, 3.23),
- drug use disorder (aOR, 1.86),
- tobacco use disorder (aOR, 1.77).
- psychiatric diseases:
- anxiety (aOR, 1.65),
- bipolar disorder (aOR, 1.51),
- depression (aOR, 1.29).
- chronic pain (aOR, 1.86),
- chronic kidney disease (aOR, 1.59),
- pressure and chronic ulcers (aOR, 1.48),
- hepatitis (aOR, 1.68).
- The rate of opioid overdose death was 363.7/100,000 among adults with disability who had substance use, psychiatric disease, and pain.
- Findings may not be generalizable.
Coauthored with Chitra Ravi, MPharm