Social Disadvantage, Risk of OUD in Chronic Pain — Evidence From a Nationwide Dataset

Background: Opioid-use disorder (OUD) continues to be a major public health concern in the United States, especially among individuals suffering from chronic pain. Despite extensive research on clinical predictors of OUD, the influence of social determinants of health (SDoH)—including socioeconomic status, education, and access to care—remains insufficiently characterized in this population. Understanding these factors is critical to addressing upstream contributors to opioid dependence. Objective: To investigate how SDoH influence the likelihood of OUD among adults with chronic pain, using data from a large, diverse, multi-institutional cohort. Design: Cross-sectional retrospective study. Methods: The All of Us Research Program dataset included population- and individual-level surveys representing multiple U.S. geographic regions. Mixed-effects multivariable regression models were used to examine associations between OUD and various SDoH domains, adjusting for potential confounders. more...