Associations Between Social Determinants of Health and Opioid-Use Disorder Among Chronic Pain Patients From a Multi-Institutional Dataset

Veena M Do; Sierra Simpson; Kathleen M Fisch; Rodney A Gabriel

doi:10.1213/ANE.0000000000007247

Associations Between Social Determinants of Health and Opioid-Use Disorder Among Chronic Pain Patients From a Multi-Institutional Dataset

Anesth Analg. 2024 Dec 23. doi: 10.1213/ANE.0000000000007247. Online ahead of print.

Authors

Veena M Do¹, Sierra Simpson², Kathleen M Fisch³, Rodney A Gabriel^{2

4}

Affiliations

¹ From the School of Medicine, University of California San Diego, San Diego, California.
² Department of Anesthesiology, Division of Perioperative Informatics, University of California San Diego, La Jolla, California.
³ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, California.
⁴ Department of Biomedical Informatics, University of California San Diego, La Jolla, California.

PMID: 39715077
DOI: 10.1213/ANE.0000000000007247

Abstract

Background: This study examined the association between opioid-use disorder (OUD)-related diagnoses (eg, opioid dependence) and social determinants of health (SDoH) among patients with chronic pain.

Methods: A cross-sectional study was performed using the All of Us dataset (including >70,000 patients) to measure associations between SDoH and OUD using population- and individual-level surveys. Mixed-effects multivariable regression models (random effect being zip code) were conducted for each of the key SDoH domains. The odds ratio (OR) and 95% confidence interval (CI) were reported.

Results: There were 71,727 participants identified to have chronic pain, of which 7272 (10.1%) had OUD. Using data from all participants with population-level survey data available (n = 71,684), the Area Deprivation Index was associated with increased odds of OUD (OR, 5.70, 95% CI, 2.34-13.83, P < .001). Being unemployed (OR, 1.91, 95% CI, 1.59-2.31, P < .001) was associated with OUD. Chronic pain patients with a college degree or greater had lower odds of having OUD (OR, 0.48, 95% CI, 0.39-0.59, P < .001). Responses to questions related to delayed medical care (OR, 1.42, 95% CI, 1.20-1.69, P < .001) and inability to afford medical care (OR, 1.37, 95% CI, 1.16-1.63, P < .001) were associated with an increased odds of OUD. Chronic pain patients who were never married or without a partner (OR, 1.49, 95% CI, 1.28-1.73, P < .001) had higher odds of OUD.

Conclusions: The study revealed a significantly greater social disadvantage metric in chronic pain individuals with OUD.