Risk Factors Associated With Opioid Medication Misuse in Community-Dwelling Older Adults With Chronic Pain

Background and Purpose:

A significant number of older adults suffer from multiple chronic diseases that require long-term medical treatment. Community-dwelling older adults often take multiple, long-term, or overdoses of pain medications to relieve chronic pain, which may lead to unintentional misuse. The present study used a biopsychosocial model to satisfy three aims: (a) to explore patterns of opioid medication use and other chronic pain management among community-dwelling older adults with chronic pain, (b) to determine whether there is a significant relationship between gender in older persons and risk for opioid medication misuse, and (c) to determine what biological, psychological, and social risk factors are associated with opioid medication misuse among community-dwelling older adults with chronic pain.

Methods:

A total sample of 163 older adults (+65) who were currently receiving opioid medications due to chronic pain was surveyed regarding demographic information, chronic pain, opioid and other prescribed medication, and the risk factors associated with opioid medication misuse. In the cross-sectional research design, the confidential survey was administered in 12 outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System. With this method of personal visits, the response rate for the study was 80.7%. Univariate, bivariate, and multivariate data analyses were conducted to address the research questions.

Results:

The findings revealed a relatively high prevalence (81.6%, n = 133) of long-term users (+4 months) of opioid medication in the sample and a high potential for the medication abuse. Only 37.4% of the participants (n = 61) were currently participating in or had previously received nonpharmacological therapy (e.g., physical therapy). A majority of the participants (62.6 %) had depended on pain medication alone. Regarding the relationship between gender and opioids misuse, no significant difference was found between older women and older men on the measure of opioid medication misuse, t = -.826 (two-tailed), p = .410. Regarding the question about risk factors associated opioid medications, the overall regression model was significant, N = 159, F = 6.131, p < .0005, and accounted for 35.5% of the variance in the independent variable by the set of independent variables, Rē = .355, Adjusted Rē = .297. Higher levels of severity of physical disability predicted lower levels of opioid medication misuse, B = -.304, t = -2.888, p = .004. Higher levels of depression predicted higher levels of opioid medication misuse, B = .287, t = 4.796, p < .0005. Higher levels of social support predicted lower levels of opioid medication misuse, B = -.081, t = 2.096, p = .038.

Conclusion and implications.

Findings indicated that physical disability, depression, and social support were significantly associated with opioid medication misuse. This study contributes to the field of social work by providing insight into the aging process and medication misuse. The suggestions for research, policy, education, and practice are a starting point for social workers to be more involved in improving the quality of life of older adults as it relates to management of chronic pain through use of medications.