Factors Predicting Opioid Use Disorder Among Older Adults With Chronic Pain

Monday, 18 November 2019

Armiel Suriaga, MSN-RN
Nursing, Florida Atlantic University, West Palm Beach, FL, USA

The opioid crisis in the United States remains unabated. The National Institute of Health or NIH (2018) reported an alarming figure about deaths related to opioid overdoses, which accounts for 115 deaths every day. The Center for Disease Control and Prevention or CDC further stated that deaths due to drug overdose climbed to 63, 632 this year, of which 66% is opioid prescription related (CDC, 2016). Addressing this opioid crisis causes a hefty economic burden in the United States, where it spent approximately $78.5 billion a year for opioid overdoses, dependence and misuse (Guy, et al. (2017).

The main cause of this opioid crisis is said to be due to excessive opioid prescription by medical providers. In the 1990s, there was a greater increase in opioid prescription because the pharmaceutical companies told the medical providers that opioid medications used to treat severe and chronic pain were not addictive. However, opioid drugs have addictive properties, and that opioids are often misused and abused, leading to patient’s death. Recent research revealed that 35% of adults 50 years and above misused their opioids (Chang, 2018).

On the other hand, the percentage of opioid prescriptions by providers elucidate disparity, where 80.1% of the total opioid prescription went to non-Hispanic whites, followed by non-Hispanic blacks at 9.0%, Hispanic 7.0% and others, 3.9% (Guy, et al., 2017). In addition, there is a significant number of older adults with opioid use disorder seeking for treatment, with Caucasians having the highest percentage at 76.6 % in 2015, followed by African Americans at 13.8%, Hispanic at 10.8% and others, 7.2% (Huhn, Strain, Tompkins, & Dunn, 2018).Netherlands & Hansen (2017) posited that the opioid epidemic reinforces racial divide where the pharmaceutical companies, medicine and biotechnology had contributed to what they call the “white opioids.” Wyatt (2013) agreed that race influences the expression of pain as well as how they seek for pain treatment, while stating that white people are more likely to misuse drugs; African-Americans were more likely to underreport pain and resort to passive coping strategies like prayers than non-Hispanic whites; and that African-Americans and Hispanics were less likely to receive pain medications than non-Hispanic whites despite reporting higher pain levels.

The questions arise: What factors influence healthcare providers to prescribe opioids to older adults with chronic pain, and withhold opioid prescription to some, who may have similar or higher pain levels? With tighter regulations concerning opioid prescriptions and the fear of addiction, drug dependency, stigma and eventual opioid use disorder from prolonged use of these narcotic analgesics, providers are caught between a rock and a hard place. It is of paramount importance that we clarify some biased assumptions about minority groups when it comes to opioid use. Knowing the factors that predict their risks for developing opioid use disorder will help providers gain confidence in enhancing prescription parity to all patients with chronic pain.

This research project will focus on the factors predicting opioid use disorder among adult minority ethnic groups in the United States. It aims to find association or correlation between variables like ethnicity, education, income level, self-reported pain level and opioid use disorder.