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For US adults, disability status may be risk factor for prescription drug misuse

Despite the current drug overdose epidemic in the U.S., little research on drug use among people with disabilities has been conducted. A recent study attempted to address this gap in the literature by examining the relationship disability status and prescription drug misuse among U.S. adults. The authors used data from the 2015 National Survey on Drug Use and Health (NSDUH), which defined prescription drug misuse as using prescription drugs without a prescription or in a way not instructed by a doctor. In 2015, the NSDUH was revised to include questions related to disability. The sample for this study was restricted to NSDUH respondents aged 18 years and older (N = 43,561). Disability status was assessed via two items that asked respondents whether they experienced difficulty completing activities of daily living (ADLs) and instrumental activities of daily living (IADLS). The former category includes activities such as making decisions and bathing, while the latter includes doing errands and going shopping. Other variables included in this analysis were demographic characteristics, heavy drinking in the past month, illicit drug use in the past year, overall health status, and psychological distress. The authors also examined the potential impact of social engagement/isolation on the relationship between drug use and disability status. These measures included marital status, employment status, educational attainment, health insurance status, and attendance at religious services in the past year. Multiple multinomial regression models were used to examine the relationships among these variables. Results indicated 3.69% of respondents reported misusing opioids in the past year, 1.14% reported misusing benzodiazepines, and 1.04% reported misusing both substances. Nearly ten percent of the sample reported a disability associated with ADLs, while just over five percent reported a disability associated with IADLs. The baseline multinomial regression model indicated respondents who reported an ADL disability were at higher risk for opioid misuse (Relative Risk Ration [RRR] = 1.64; 95% Confidence Interval [CI] = 1.24, 2.17), but not the other two types of misuse. Respondents who reported an IADL disability were at increased risk for both benzodiazepine misuse (RRR = 2.21; 95% CI = 1.31, 3.72) and the misuse of both opioids and benzodiazepines (RRR = 3.31; 95% CI = 1.97, 5.55), but not opioid misuse alone. However, after adding the health measures to the model, the relationships between ALD disability status and opioid misuse and IADL disability status and benzodiazepine misuse were no longer significant. Only the relationship between IADL disability status and misuse of both opioids and benzodiazepines remained significant (RRR = 1.73; 95% CI = 1.06, 2.80). In the final model, the authors added social engagement/isolation measures to the baseline model, after which all of the significant relationships in the baseline model remained significant. ADL disability status (RRR = 1.48; 95% CI = 1.10, 1.99) was significantly associated with opioid misuse, while IADL disability status was not. Similarly, IADL disability status remained significantly associated with both benzodiazepine misuse (RRR = 2.04; 95% CI = 1.14, 3.67) and the misuse of both opioids and benzodiazepines (RRR = 3.19; 95% CI = 1.92, 5.27), but ADL disability status was not.

Take away: Using National Survey on Drug Use and Health (NSDUH) data, the authors documented adults who reported having a disability were at increased risk of misusing opioids alone, benzodiazepines alone, or both substances, compared to respondents without disabilities.

Ford, J.A., Sberna Hinojosa, M. & Nicholson, H.L. (2018). Disability status and prescription drug misuse among U.S. adults. Addictive Behaviors [published online ahead of print May 28, 2018] doi: 10.1016/j.addbeh.2018.05.019

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