Psycho-Social Correlates of Opioid Use Disorder among the US Adult Population: Evidence from the National Survey on Drug Use and Health, 2015–2018

Abstract

Background

The United States (US) has experienced an opioid epidemic over the last two decades. Drug overdose deaths increased by 21% from 2015 to 2016, with two-thirds of these deaths attributed to opioid use disorder (OUD). This study assessed the psycho-social correlates associated with OUD over 2015–2018 in the US. Methods: This study used data collected from 171,766 (weighted = 245,838,163) eligible non-institutionalized US adults in the pooled National Survey on Drug Use and Health from 2015–2018. Survey-weighted descriptive, bivariate, and multivariable analyses were performed to assess the psycho-social correlates of OUD. Results: About 0.85% of the respondents reported having OUD in the past year. About one-quarter (26.3%), one-sixth (14.8%), and half (47.3%) of the respondents with OUD reported alcohol, marijuana, and nicotine dependence, respectively. One-sixth (16.7%) had a criminal justice involvement history, and almost one-third (30.8%) experienced a major depressive episode (MDE) in the past year. In multivariable analysis, ≤64 years, White race, male gender, lower educational attainment, unemployment, large metro area residence, history of alcohol, marijuana, nicotine use disorder, history of criminal justice involvement, and MDE in previous year were associated with higher odds of OUD. In contrast, being married, non-Hispanic African American, non-Hispanic Other, and Hispanic ethnicity, good physical health, private health insurance, and higher risk perception about addictive substance use were associated with lower odds of OUD. Conclusions: OUD is more prevalent among certain sociodemographic groups in the US. Targeted interventions focusing on young, White, unmarried, male, and uninsured/Medicaid/Medicare populations should be implemented to reduce the OUD.

Keywords:

• Opioid use disorder
• major depressive episode
• alcohol use disorder
• marijuana use disorder
• nicotine dependence
• criminal justice involvement
• USA

Acknowledgements

The authors acknowledge the Substance Abuse and Mental Health Services Administration (SAMHSA) for use of the National Survey on Drug Use and Health (NSDUH) datasets.

Author contributions

MRH had full access to the data used in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed in conceptualization of the study and study design, MRH acquired the data, MRH and SK performed statistical analysis, RDG conducted the literature review, MRH and RDG wrote the first draft, MJB, SK, BO, and XL contribute in finalizing the manuscript. All authors read and approved the final draft.

Declaration of interest

The authors report no conflicts of interest.

Funding/support

This research was not supported by any specific research funding.

Role of the funder/sponsor

The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data availability statement

The data that support the findings of this study are openly available in Substance Abuse & Mental health Data Archive (SMHDA) at https://www.datafiles.samhsa.gov/study-series/national-survey-drug-use-and-health-nsduh-nid13517.

Additional information

Funding

BO and XL are supported by National Institute of Allergy and Infectious Diseases (NIAID)-funded R01 award (Award Number R01AI127203). MJB is supported by the National Institute of Mental Health (NIMH)-funded K01 award (Award Number K01MH115794). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.