Health, Socioeconomic Status, and Opioid Use Disorder: Risk Factors Among Individuals With Nonmedical Opioid Use

Area of Science:

• Public Health
• Sociology
• Addiction Medicine

Background:

• Rising rates of opioid use disorder (OUD) present a significant public health challenge.
• Limited understanding exists regarding the interplay between socioeconomic status (SES) and health factors in OUD development.

Purpose of the Study:

• To investigate how self-reported health status moderates the association between SES and OUD in adults engaging in nonmedical opioid use.
• To identify specific SES indicators and health conditions that influence OUD risk.

Main Methods:

• Analysis of data from 10,984 adults (aged ≥18) from the 2015-2019 National Survey on Drug Use and Health.
• Logistic regression models were employed to assess OUD odds based on self-reported health (fair/poor vs. good/very good/excellent) and SES indicators (education, income, employment, marital status).
• Interaction terms were utilized to determine if health status modifies the SES-OUD relationship.

Main Results:

• Fair/poor self-reported health was associated with increased odds of OUD.
• Higher SES indicators, including college graduation and employment, were linked to lower OUD odds overall.
• Crucially, among individuals reporting fair/poor health, higher SES (college degree, income ≥$75,000, employment) corresponded to significantly increased OUD odds.
• Conversely, widowed/divorced/separated and never-married individuals reported lower OUD odds compared to married individuals, particularly within the fair/poor health group.

Conclusions:

• Self-reported health status is a significant moderator of the relationship between SES and OUD.
• Individuals with fair/poor health and higher SES face a disproportionately elevated risk for OUD.
• Public health and clinical interventions for OUD should integrate considerations of both SES and health status for effective prevention and treatment strategies.