{"title":"Social Withdrawal and Prescription Opioid Misuse Among Older Adults in the United States.","authors":"Jack Lam, Michael Vuolo, Brian Kelly","doi":"10.1093/geroni/igaf052","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>The literature indicates an association between social isolation and substance use. Though related, social withdrawal is a construct that has received less attention. Given that prescription drugs are commonly misused by older adults, this paper contributes to the literature by examining the association between social withdrawal and prescription opioid misuse.</p><p><strong>Research design and methods: </strong>We use data from 2009 to 2022 U.S. National Survey on Drug Use and Health, focusing on respondents 50+ (<i>N</i> = 111,386; 54.8% female; 74.1% non-Hispanic White). Social withdrawal is measured with 3 items from the WHO Disability Assessment Scale, individually and as a scale, capturing the level of social withdrawal severity experienced when going out of the home, dealing with strangers, and participating in social activities. Our outcome is past-year prescription opioid misuse. Logistic regression models consider the association between these 2 measures. Models account for underlying mental health alongside additional covariates.</p><p><strong>Results: </strong>Levels of social withdrawal and prescription opioid misuse remained relatively constant across observation years. A significant association exists between social withdrawal and past-year prescription opioid misuse. We find increasing odds of past-year prescription opioid misuse across social withdrawal severity levels. Severe social withdrawal across measures is associated with 1.59 (95% CI = 1.28, 1.98) to 2.1 (95% CI = 1.74, 2.48) times higher odds of past-year prescription opioid misuse relative to no social withdrawal. Predicted probabilities of misuse are 1% among those with no social withdrawal, but 6% among those experiencing severe social withdrawal. A nonsignificant interaction shows this relationship is consistent across years. These estimates are robust to numerous controls and alternative specifications.</p><p><strong>Discussion and implications: </strong>Prescription opioid misuse is associated with social withdrawal. Social withdrawal is bound up with, and yet independent of, mental and physical health. Addressing the social causes of social withdrawal, as well as mental and physical health, could advance addressing opioid misuse among older adults.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf052"},"PeriodicalIF":4.9000,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210946/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovation in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geroni/igaf052","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: The literature indicates an association between social isolation and substance use. Though related, social withdrawal is a construct that has received less attention. Given that prescription drugs are commonly misused by older adults, this paper contributes to the literature by examining the association between social withdrawal and prescription opioid misuse.
Research design and methods: We use data from 2009 to 2022 U.S. National Survey on Drug Use and Health, focusing on respondents 50+ (N = 111,386; 54.8% female; 74.1% non-Hispanic White). Social withdrawal is measured with 3 items from the WHO Disability Assessment Scale, individually and as a scale, capturing the level of social withdrawal severity experienced when going out of the home, dealing with strangers, and participating in social activities. Our outcome is past-year prescription opioid misuse. Logistic regression models consider the association between these 2 measures. Models account for underlying mental health alongside additional covariates.
Results: Levels of social withdrawal and prescription opioid misuse remained relatively constant across observation years. A significant association exists between social withdrawal and past-year prescription opioid misuse. We find increasing odds of past-year prescription opioid misuse across social withdrawal severity levels. Severe social withdrawal across measures is associated with 1.59 (95% CI = 1.28, 1.98) to 2.1 (95% CI = 1.74, 2.48) times higher odds of past-year prescription opioid misuse relative to no social withdrawal. Predicted probabilities of misuse are 1% among those with no social withdrawal, but 6% among those experiencing severe social withdrawal. A nonsignificant interaction shows this relationship is consistent across years. These estimates are robust to numerous controls and alternative specifications.
Discussion and implications: Prescription opioid misuse is associated with social withdrawal. Social withdrawal is bound up with, and yet independent of, mental and physical health. Addressing the social causes of social withdrawal, as well as mental and physical health, could advance addressing opioid misuse among older adults.
期刊介绍:
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.