Social Determinants of Opioid Use among Patients in Rural Primary Care Settings

ABSTRACT

Opioid use and misuse are a widespread problem across the United States. Identifying and targeting social determinants of opioid use may help to identify predictive factors to influence intervention and policy. The purpose of this study was to identify social determinants of opioid use frequency among patients seeking primary care in rural Alabama healthcare facilities. This survey-based study focused on a patient population located in rural west Alabama surveyed for a screening, brief intervention, and referral to treatment program. The screening tool contained demographic information and questions regarding the social determinants of health and opioid use, among others. Adjusted incidence rate ratios (IRRs) for the relationship between social determinants of health and opioid use frequency (in days/month) were estimated in Poisson regression models. Eleven percent of the population self-reported opioid use in the past 30 days. Three social determinants of health measured (level of education, housing stability, and employment status) were identified as having a significant association with the frequency of opioid use. Targeting certain social determinants of health may allow for further predictive interventions to mitigate opioid misuse and potential fatality or mortality.

KEYWORDS:

• Opioids
• primary care
• rural
• SBIRT
• social determinants

Acknowledgments

The authors would like to thank the Substance Abuse and Mental Health Services Administration (SAMHSA) for funding to conduct this project.

Ethics approval and consent to participate

This study’s research protocol was reviewed and approved by the lead author’s IRB. All participants consented to participate in this study.

Human and animal rights

The procedures of this study were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration.

Disclosure statement

No potential conflict of interest was reported by the author(s).