(280) Trends in Opioid Use for Chronic Joint Pain in Mid- and Late-Life Black Adults: Results from a Mixed Methods Inquiry

Abstract

Before the height of the opioid crisis, research had well-established older Blacks’ reluctance to use opioids due to concerns about side effects, addiction, and overdose. Our study found that 30% of Blacks used opioid medications within the past 30 days to manage joint pain. Given this proportion of users, we investigated demographic, social, clinical, and behavioral patterns distinguishing opioid consumers and non-consumers. Descriptive statistics, chi-square, one-way ANOVA, and qualitative content analysis summarize data for community-dwelling Black adults (≥50 years age) with symptomatic osteoarthritis. Although non-significant, opioid users (N= 33) were younger (50-64 years), female, unmarried, and lived in rural and urban areas. A marginal trend toward significance emerged for users without social support (p = .082). Interestingly, adults without a high school diploma or with a graduate degree (≥Master's) were significantly less likely to use opioids (p = .026) compared to those with a high school or college education (≤Bachelor's). Not surprisingly, opioid consumers suffered more intense chronic joint pain (=6.33±2.12, p = .003) than non-consumers (=5.10±1.87) and greater interference on physical function (p = .003). Opioids were primarily used daily (16.4%) or ‘as needed’ (11.8%). Despite greater pain, most opioid users did not use behavioral or medical strategies, such as massage (p = .023), assistive mobility aides (p = .014), or joint injections (p = .044). Both consumers and non-consumers shared concerns that providers give “more of this narcotic type medication to cover the pain up, blocks the brain from thinking it's pain.” “After so many years takin’ the medicine, you don't wanna get addicted to it… really it [managing pain] is mental, and although they can give you non-narcotic pain medicine, medicine is not the key.” Findings suggest that opioids are used by a very specific sub-group of Black adults who are middle-aged with mid-level education, no social support, more pain, and worse physical function.