How socioeconomic status affects opioid use: An analysis of pain patients based on NHANES

Res Social Adm Pharm. 2026 Mar 24:S1551-7411(26)00065-3. doi: 10.1016/j.sapharm.2026.03.004. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigates the association between socioeconomic status (SES) and opioid utilization behaviors among U.S. adults experiencing chronic or recurrent pain.

METHODS: Using data from the 2011-2018 NHANES, we carried out a cross-sectional assessment. A cohort of 978 adults aged 18 and above who reported pain lasting at least one month were included. The primary outcome was the self-reported number of days on which prescription opioid medications were used across the preceding 30-day period, which reflects the frequency, not the dose or intensity, of opioid use. The main predictors were SES indicators, comprising poverty-income ratio (PIR), employment status and retirement status. Negative binomial regression models were used, adjusting for demographic and clinical covariates.

RESULTS: Unemployed and low-income individuals demonstrated significantly longer durations of opioid use than their employed and higher-income counterparts. Patients with health insurance coverage also reported more opioid use days than uninsured patients. The interaction between SES and pain type revealed that unemployed individuals with oral or chest pain had notably higher opioid use durations. Stratified analyses showed that the effects of SES on opioid use varied across subgroups defined by age, gender, race, and comorbidity profiles.

CONCLUSION: Socioeconomic disparities are key determinants of shaping opioid consumption behaviors among chronic pain patients. Findings underscore the need for personalized pain management strategies and policy interventions that account for patients' socioeconomic conditions to mitigate the risk of opioid overuse.

PMID:41934044 | DOI:10.1016/j.sapharm.2026.03.004