Sociodemographic and Clinical Predictors of Prescription Opioid Use in a Longitudinal Community-Based Cohort Study of Middle-Aged and Older Adults.

OBJECTIVES

Identifying factors associated with opioid use in middle-aged and older adults is a fundamental step in the mitigation of potentially unnecessary opioid consumption and opioid-related harms.

METHODS

Using longitudinal data on a community-based cohort of adults aged 50-90 years residing in Johnston County, North Carolina, we examined sociodemographic and clinical factors in non-opioid users ( = 786) at baseline (2006-2010) as predictors of opioid use at follow-up (2013-2015). Variables included age, sex, race, obesity, educational attainment, employment status, household poverty rate, marital status, depressive symptoms, social support, pain catastrophizing, pain sensitivity, insurance status, polypharmacy, and smoking status.

RESULTS

At follow-up, 13% of participants were using prescription opioids. In the multivariable model, high pain catastrophizing (adjusted odds ratio; 95% confidence interval = 2.14; 1.33-3.46), polypharmacy (2.08; 1.23-3.53), and history of depressive symptoms (2.00; 1.19-3.38) were independent markers of opioid use.

DISCUSSION

Findings support the assessment of these modifiable factors during clinical encounters in patients ≥ 50 years old with chronic pain.