Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder

Dahlman, Disa; Edwards, Alexis C.; Sundquist, Jan; Håkansson, Anders; Sundquist, Kristina

doi:10.1186/s13011-021-00409-3

Cited by 13 publications

(10 citation statements)

References 35 publications

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“…Beyond epidemiologic estimates of co-occurrence, SUDs and psychiatric disorders have also been demonstrated to be risk markers for severe opioid-related outcomes, such as opioid overdose (41). Educational attainment and economic hardship have also been associated with higher rates of opioid overdose and opioid overdose-related deaths (42). These patterns of genetic correlation are consistent with the complex clinical presentation of OUD and underscore the need for prevention and intervention in underserved populations and individuals with chronic and severe OUD.…”

Section: Discussionmentioning

confidence: 94%

Genome-wide association study and multi-trait analysis of opioid use disorder identifies novel associations in 639,709 individuals of European and African ancestry

Deak

Zhou

Galimberti

et al. 2021

Preprint

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BackgroundDespite the large toll of opioid use disorder (OUD), genome-wide association studies (GWAS) of OUD to date have yielded few susceptibility loci.MethodsWe performed a large-scale GWAS of OUD in individuals of European (EUR) and African (AFR) ancestry, optimizing genetic informativeness by performing MTAG (Multi-trait analysis of GWAS) with genetically correlated substance use disorders (SUDs). Meta-analysis included seven cohorts: the Million Veteran Program (MVP), Psychiatric Genomics Consortium (PGC), iPSYCH, FinnGen, Partners Biobank, BioVU, and Yale-Penn 3, resulting in a total N=639,709 (Ncases=20,858) across ancestries. OUD cases were defined as having lifetime OUD diagnosis, and controls as anyone not known to meet OUD criteria. We estimated SNP-heritability (h2SNP) and genetic correlations (rg). Based on genetic correlation, we performed MTAG on OUD, alcohol use disorder (AUD), and cannabis use disorder (CanUD).ResultsThe EUR meta-analysis identified three genome-wide significant (GWS; p≤5×10−8) lead SNPs—one at FURIN (rs11372849; p=9.54×10−10) and two OPRM1 variants (rs1799971, p=4.92×10−09 ; rs79704991, p=1.37×10−08; r2=0.02). Rs1799971 (p=4.91×10−08) and another OPRM1 variant (rs9478500; p=1.95×10−8; r2=0.03) were identified in the cross-ancestry meta-analysis. Estimated h2SNP was 12.75%, with strong rg with CanUD (rg =0.82; p=1.14×10−47) and AUD (rg=0.77; p=6.36×10−78). The OUD-MTAG resulted in 18 GWS loci, all of which map to genes or gene regions that have previously been associated with psychiatric or addiction phenotypes.ConclusionsWe identified multiple OUD variant associations at OPRM1, single variant associations with FURIN, and 18 GWS associations in the OUD-MTAG. OUD is likely influenced by both OUD-specific loci and loci shared across SUDs.

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Section: Discussionmentioning

confidence: 94%

Genome-wide association study and multi-trait analysis of opioid use disorder identifies novel associations in 639,709 individuals of European and African ancestry

Deak

Zhou

Galimberti

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Most importantly, the participants in the medical aid program group, who are too poor to pay their insurance premiums or have difficulty supporting themselves financially, tend to take more opioids and undergo interventional procedures for the treatment of LBP and/or NP. A previous Swedish cohort study reported that individuals receiving social welfare had a higher risk of incident opioid overdose 20. Moreover, a cross-sectional study in the UK reported that lower SES was associated with increased opioid prescription 21.…”

Section: Discussionmentioning

confidence: 97%

Association between socioeconomic status and treatment in patients with low back or neck pain: a population-based cross-sectional study in South Korea

Song

2023

Reg Anesth Pain Med

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IntroductionSocioeconomic status affects the treatment of patients with low back pain and/or neck pain. We examined the relationship between socioeconomic status (occupation and household income level) and treatments such as chronic opioid use and interventional procedures among these patients.MethodsData from the National Health Insurance Service database in South Korea were used in this population-based cross-sectional study. Approximately 2.5% of adult patients diagnosed with low back pain and/or neck pain between 2010 and 2019 were selected using a stratified random sampling technique and included in the analysis.ResultsWe analyzed the data of 5,861,007 patients with low back pain and/or neck pain in total. Among them, 4.9% were chronic opioid users and 17.7% underwent interventional procedures. Healthcare workers and unemployed individuals had 18% lower and 6% higher likelihood of chronic opioid use compared with office workers, respectively. Those with a very low household income had 18% higher likelihood of chronic opioid use than those with a poor household income. Other workers and unemployed individuals had 4% and 8% higher likelihood of undergoing interventional procedures than office workers, respectively. Healthcare workers had 5% lower likelihood of undergoing interventional procedures than office workers. Patients with middle, high, and very poor household incomes had a higher likelihood of undergoing interventional procedures, while those in the very high household income group had a lower likelihood of undergoing interventional procedures than those with poor household incomes.ConclusionsSocioeconomic status factors are associated with treatment in patients with low back pain and/or neck pain.

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“…The periphery in Israel is generally considered to be less wealthy [ 26 , 27 ]. The higher proportion and MME of opioids in deprived areas are not unique to Israel, though each country has a different intersection of periphery and low SES [ 28 ]. A study from the United States reported a significantly higher risk for opioid use and opioid-associated mortality in more deprived areas in the country [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020

Adler,

Cohen,

Shapiro Ben Daviv

et al. 2024

Isr J Health Policy Res

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Background The use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic background. Methods This cross-sectional study included all adult Maccabi Healthcare Services (MHS) patients who filled at least one prescription for opioids during the past decade. In order to standardize dosages and compare different opioid medications, we used the Morphine Milligram Equivalent (MME) conversion factor. We performed The Mann–Kendall test with autocorrelation correction to assess each trend. We then checked the differences between the trends with the Mann–Whitney test (for periphery) and the Kruskal Wallis (for SES and ethnic background). Results Between the years 2010–2020, 261,270 MHS members met the study's inclusion criteria. The proportions of opioids consumption were 23.9/1000 patients in 2010 and 27.6/1000 patients in 2020, representing a 15% increase. The average daily consumption of opioids was 4.6 and 10.5 MME in 2010 and 2020, respectively, an increase of 227%. The daily MME during 2020 was higher for residents of the periphery compared to non-periphery residents (daily MME of 14.0 compared to 10.1, respectively). Average daily MME increased gradually during the study period for all levels of SES; the values were highest for the low SES group and the lowest for the high SES group (daily MME in 2020 for the lowest, middle, and high SES groups were 15.2 vs. 11.8 vs. 6.7 respectively). Conclusions This study highlights that the primary concern in the increase of opioid use is the increasing dosages. The increase in the number of patients using opioids is also significant but to a minor extent. These phenomena disproportionately impact vulnerable populations. Education programs should be offered to physicians regarding the possible harms of long-term use of opioids. These programs should emphasize the risk factors associated with the development of opioid use disorder (OUD) and the caution needed when increasing dosages or switching to higher-potency drugs. Pain clinics and centers for rehabilitation for patients with chronic pain or OUD should be available, not only in central areas but also in the periphery of the country. These clinics and centers should use a holistic approach and a multidisciplinary team that includes specialists in pain and addiction. They should be financially accessible for patients from low SES group and provide solutions in multiple languages.

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Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder

Cited by 13 publications

References 35 publications

Genome-wide association study and multi-trait analysis of opioid use disorder identifies novel associations in 639,709 individuals of European and African ancestry

Genome-wide association study and multi-trait analysis of opioid use disorder identifies novel associations in 639,709 individuals of European and African ancestry

Association between socioeconomic status and treatment in patients with low back or neck pain: a population-based cross-sectional study in South Korea

Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020

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