The Relationship between Disability, Psychological Distress, and Opioid Use

Background and Purpose: The Center for Disease Control and Prevention (CDC) identifies opioid addiction as one of the greatest issues facing the United States, and the worst epidemic of its kind in the country’s history. Approximately two million people in the United States present with an opioid use disorder (OUD) diagnosis. Mean annual estimated medical costs for opioid abusers were $15,884 in 2003, compared to $1,830 for individuals not abusing opioids, representing an estimated $78.5 billion in annual costs. Many of the values issued by the National Association of Social Workers encourage social workers to intervene and assist those impacted by substance abuse disorders. These include social justice, the importance of human relationships, and competence.

The purpose of this quantitative study was to examine the relationship between these variables and answer the following four research questions. What is the impact of physical disability on psychological distress? What is the impact of emotional disability, physical disability, and psychological distress on opioid misuse? Do overall health status, education level, income level, and opioid misuse affect emotional disability? Do overall health status, education level, income level, and opioid misuse affect psychological distress?

Methods: A secondary data analysis of the 2017 National Survey on Drug Use and Health (NSDUH) was performed to explore these relationships. The sample size of the study was n = 56,276. Linear regression, logistic regression, and ANOVA with post hoc tests were utilized to analyze the sample. Approval to conduct this study was granted by the Millersville University Institutional Review Board.

Measures being analyzed include emotional disability, physical disability, psychological distress, opioid use, income, education, and health status.

Results: One of the most striking results was that for each unit increase in physical difficulty score, an individual was 1.238 times more likely to have misused opioids in the past year. Lower emotional disability scores were associated with better health, higher income, and abstinence from opioid use, particularly prescription opioids. Unexpectedly higher education is associated with higher emotional disability scores. Lower psychological distress scores are associated with better health, higher income, higher education, and abstinence from opioid use.

Conclusion and Implications: The results of this study suggest physical disability, health, income, and education affect levels of psychological distress and emotional disability. In turn, psychological distress and emotional disability are contributing factors of opioid misuse. Suggestions are provided on how to mitigate the effect these variables have on opioid use. It is hoped that this study will be expanded upon by other social workers with future research exploring these complex relationships. There is a vital need for social workers and their clients to be educated on the risk factors of opioid use that were explored by this study. This knowledge is a crucial first step in ensuring necessary prevention services are provided to those at risk. Social workers can utilize this research to update their biopsychosocial assessments of clients, ensuring that they are aware of all risk factors of opioid use.