Disability and Opioid Pain Reliever Use in Reproductive-Aged Women: An Analysis of a Canadian Cross-Sectional Survey

Prescription opioid analgesic use among reproductive-aged women is prevalent in North America. Women with disabilities experience high rates of pain and structural barriers to accessing resources, potentially increasing their likelihood of opioid use and harm. Yet, few studies have examined opioid analgesic use in this population. This study compared the use of opioid pain relievers and nonmedical opioid use in reproductive-aged women with and without disabilities across Canada.

We analyzed data from the 2018 Canadian Community Health Survey for 11,062 women aged 15-49 years. Disability status (30.6%) was determined using the Washington Group Short Set on Functioning. Modified Poisson regression was used to calculate prevalence ratios (PRs) for use of opioid pain relievers within the past 12 months, comparing women with and without disabilities, and by disability severity (mild, moderate/severe) and number of impacted functional domains (1, ≥2). Multivariable models adjusted for sociodemographic factors and health behaviors.

Women with disabilities were more likely than those without disabilities to use opioid pain relievers (19.6% versus 10.3%, adjusted prevalence ratio (aPR): 1.71, 95% confidence intervals [CI]: 1.47-1.99) and nonmedical opioids (6.2% versus 3.0%, aPR: 1.77, 95% CI: 1.28-2.43). A dose-response relationship was observed, with greater differences among women with moderate/severe disabilities and disabilities in ≥2 functional domains, compared with women without disabilities.

These findings suggest a need for comprehensive education for health care providers on disability and pain management. In their early reproductive years, women with disabilities may benefit from accessible education and counseling on the risks and benefits of opioid pain relievers, with a focus on addressing social determinants of health.