opioid misuse raises suicide risk for people with disabilities

the results come on the heels of previous research that found that people with disabilities are prescribed more opiates and more likely to abuse them than those without a disability.

by dave yasvinski

published dec 13, 2022

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23 per cent on medicare with a disability are chronic opioid users

study looked at how people with disabilities are coping in the opioid crisis that has plagued the u.s. getty

a new study has found that people with disabilities who misuse medical opioids are 73 per cent more likely to attempt suicide than those who avoid the powerful painkillers. the study, published in the journal substance use and misuse, is one of the few to focus on how people with disabilities — a group that may already be at higher risk of suicide — are coping through an opioid crisis that has plagued the u.s. (and, to a lesser extent, canada) since the 1990s. according to the country’s department of health and human services, roughly 10.1 million people misused opioids in 2019, with an estimated 48,000 overdosing on the drugs.

although the study found that opioid misuse also increased the risk of suicide among people without disabilities (who were 37 per cent more likely to plan the event), the risks to people with disabilities was a far more glaring concern.

“suicide can be understood as a severe expression of psychological distress and people with disabilities are likely under-identified and under-treated for mental health issues which may result in increased risks for suicidality, especially in the context of the opioid epidemic,” said keith chan, lead author of the study and an assistant professor at hunter college in new york.

the study, which was based on data from over 38,000 adults who participated in the u.s. national survey on drug use and health in 2019, examined the link between non-medical prescription opioid misuse and suicide risk in people with and without disabilities. of this group, 1,621 (or 3.6 per cent) said they had misused prescription opioids over the past year. misuse was defined as any use of the powerful drugs that was not directed by a doctor. the team found that twice as many people who misused the drugs were disabled compared to those who did not (six per cent vs. three per cent).

people who misused opioids were more likely to have serious thoughts of suicide, make suicide plans and have made a suicide attempt in the past year. in addition to being mostly young, male, unmarried and living on a low income, this group was less likely to have graduated from college.

the team also found that drug misusers with a disability were more likely than non-disabled misusers to report suicidal thoughts (12.6 per cent vs. 4.2 per cent), make a suicide plan (5.5 per cent vs. 1.3 per cent) or have made a suicide attempt in the past year (3.9 per cent vs. 0.8 per cent). the findings held even after accounting for other variables, such as other substance use, mental health and access to health care.

the results are concerning in light of previous research finding that people with disabilities are prescribed more opiates and are more likely to abuse them than those who do not have a disability. according to the current study, 23 per cent of medicare beneficiaries with a disability are chronic opioid users, with many using the drugs to help deal with the difficult feelings and emotions that can accompany their condition.

in addition to highlighting the need for more investment in medical health infrastructure, researchers said the study may lead to a longitudinal follow up that takes a closer look at the range of ages and disability types most likely to misuse prescription medication and how these populations get access to treatment.

“many people with disabilities have real and ongoing needs to manage pain and more research is needed to identify alternatives that can be effective while addressing mental health for this population,” chan said. “we recommend that healthcare professionals who work with people with disabilities take into account the risks of suicide for those with a history of prescription opioid misuse. there is a need for effective mental health services tailored for people with disabilities to address the impact of the opioid epidemic.”