Research connects education, depression and more to prescription opioid abuse in adults over age 50

Marlene Robinson, University of Buffalo
March 22, 2018
By Marlene Robinson, University of Buffalo
BUFFALO, N.Y. – 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.

The study, which surveyed 130 participants in Western New York, investigated the risk factors for prescription opioid misuse in adults with chronic pain older than 50. The research concluded that those who attended at least some college were 2.5 times more likely to misuse opioids than those who did not.

The study also found that the risk for opioid misuse in older adults was nearly 13 times greater for illicit drug users than non-users, and almost 6 times greater for individuals with moderate depression.

Understanding these factors can aid health care professionals in identifying high-risk older adults, a population that is more sensitive to opioids due to the effects of aging on the body, says Yu-Ping Chang, PhD, author and Patricia H. and Richard E. Garman Endowed Professor in the UB School of Nursing.

Of U.S. adults 50 or older who visited the emergency room for drug toxicity, opioid pain relievers were involved in nearly 44 percent of cases, according to the Substance Abuse and Mental Health Services Administration.

"As the baby boomer generation ages and more patients are prescribed opioids, the number of individuals evidencing prescription opioid misuse and abuse is likely to become even greater," says Chang, also the associate dean for research and scholarship in the School of Nursing.

"Older adults have a more complex medication regimen because of other co-existing chronic conditions. Any increased opioid dose without proper adjustment by the provider can potentially cause harm."

The research, published in Nursing Outlook, is one of the few studies to focus on opioid misuse in older adults.

Surveys tested patients for opioid misuse, illicit drug use, alcohol abuse, anxiety, depression, levels of pain and the interference of pain with daily activities.

Nearly 35 percent of participants reported misusing prescription opioids in the past month. Among those, individuals with a college degree or moderate depression, or who used illegal drugs were linked to increased risk for opioid abuse. Higher levels of pain that interfered with an individual's ability to work was also a significant predictor of misuse.

"Previous studies have not found any association between education level and prescription opioid misuse. More research is needed to better understand the potential mechanism of such an association," says Chang.

"Furthermore, patients with a moderate level of depression are at a greater risk of prescription opioid misuse than those with mild or severe depression. It is possible that depressed patients take additional opioids to cope with their non-pain symptoms. Yet, patients who experienced severe depression might have different ways of handling their depression other than using more opioids. Interventions addressing co-existing mental health problems might be helpful to prevent prescription opioid misuse in this population."

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