Abstract

Prescription opioid misuse remains a serious public health concern in the United States. While considerable research attention is paid to this issue, a relatively small number of studies focus specifically on older adult misuse, and even less stratify findings by race-ethnicity. The goal of this study was to identify prevalence and correlates of prescription opioid misuse among Black and White older adults (age 50+). Data used for this study (n = 21,488) come from a pooled sample (2016–2018) of the National Survey on Drug Use and Health. Stratified and pooled multivariable logistic regression models were estimated to determine which factors were associated with an increase/decrease in risk among Black and White older adults, adjusting for other relevant variables. Results showed that past-year prescription opioid misuse prevalence rates among older adults were equal for Blacks (2.5%) and Whites (2.5%), which was somewhat surprising given that prior studies generally show rates to be higher among Whites. Our analyses, stratified by race-ethnicity, also revealed notable Black–White variations in risk/protective factors. These findings show that Black and White older adults now account for a similar share of the prescription opioid misusing population and interventions aimed at preventing misuse among older adults should be targeted equally at both groups. Despite equal prevalence rates, Black and White older adults have unique risk profiles, suggesting that effective interventions will require tailoring. These findings are important in that they enhance the ability of opioid prescribers to identify high-risk older adult patients and can help make interventions more culturally relevant.

摘要

在美国，处方阿片类药物滥用仍然是一个严重的公共卫生问题。虽然对这个问题给予了相当多的研究关注，但相对较少的研究专门关注老年人的滥用，甚至更少按种族对研究结果进行分层。本研究的目的是确定黑人和白人老年人（50 岁以上）处方阿片类药物滥用的流行率和相关性。本研究使用的数据（n = 21,488）来自全国药物使用与健康调查的汇总样本（2016-2018 年）。估计分层和汇总多变量逻辑回归模型以确定哪些因素与黑人和白人老年人的风险增加/减少相关，并调整其他相关变量。结果显示，过去一年中老年人的处方阿片类药物滥用流行率在黑人（2.5%）和白人（2.5%）中是相等的，这有点令人惊讶，因为之前的研究通常显示白人的滥用率更高。我们按种族分层的分析还揭示了风险/保护因素的显着黑白差异。这些研究结果表明，黑人和白人老年人现在在处方阿片类药物滥用人群中的比例相似，旨在防止老年人滥用的干预措施应同样针对这两个群体。尽管患病率相同，但黑人和白人老年人具有独特的风险特征，这表明有效的干预措施需要量身定制。这些发现很重要，因为它们提高了阿片类药物处方者识别高危老年患者的能力，并有助于使干预措施更具文化相关性。