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Work Disability and Fatal Opioid Overdose Risk in the United States: A Cohort Study.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Rising national rates of opioid-involved overdose deaths are a major public health crisis.
  • Limited understanding exists regarding the specific risks faced by US adults with work disability in relation to opioid overdose.

Purpose of the Study:

  • To investigate the association between work disability and the risk of fatal opioid overdose among US adults.
  • To identify demographic subgroups within the work-disabled population that face elevated risks.

Main Methods:

  • A prospective cohort study utilized a nationally representative sample of 2,403,000 US adults (ages 20-61) from the 2008 American Community Survey.
  • Data were followed through 2019 to identify opioid overdose deaths, with survival analyses (Cox models) employed to calculate adjusted hazard ratios.
  • Covariates included age, sex, race/ethnicity, marital status, education, residence, region, employment, and income, with further stratification by impairment type.

Main Results:

  • Adults with work disability had a 4.3 times higher unadjusted rate of fatal opioid overdose (44.1 vs 9.4 per 100,000).
  • After full adjustment, adults with work disability had a 1.82 times higher hazard of opioid overdose compared to those without.
  • The association was notably stronger for females (HR=2.44), older adults (HR=1.93), and Hispanic adults (HR=2.80).

Conclusions:

  • Work disability is a significant risk factor for fatal opioid overdose in US adults.
  • Targeted interventions are crucial for vulnerable subgroups, including women, older adults, and Hispanic individuals with work disability.
  • Policy and clinical initiatives are needed to mitigate opioid overdose risks for adults with work disability.