Opioid abuse decreases during pandemic, yet higher rates persist for sexual minorities

New Orleans — Although opioid abuse in the U.S. is trending downward overall, it remains higher among non-heterosexuals than heterosexuals, according to an analysis of national survey data being presented at the ANESTHESIOLOGY^® 2022 annual meeting.

“This is the first analysis to look at the status of opioid abuse during COVID-19 in this population,” said Mario Moric, M.S., lead author of the research and a biostatistician at Rush University Medical Center, Chicago. “We thought the pandemic would prompt a spike in opioid abuse, but we are happy that this was not the case. However, the higher level of abuse among sexual minorities compared to heterosexuals is a concern. It underscores the need to focus on the risk factors and formulate strategies to reduce opioid abuse in this vulnerable population.”

The researchers analyzed data collected through the annual National Survey on Drug Use and Health, which provides estimates of the prevalence of alcohol and drug use in the United States. More than 89,000 survey participants self-reported their sexual identity as heterosexual, homosexual or bisexual. The authors determined opioid abuse decreased between 2019 and 2020 among all three groups: from 3.5% to 3.2% for heterosexuals; 7.4% to 4.6% for homosexuals; and 10.3% to 7.6% for bisexuals. Overall, opioid abuse among adults 18 and older, regardless of sexual identity, declined by nearly 1 million, from 8 million adults in 2019 to 7.1 million adults in 2020.

While opioid abuse went down, drug overdose deaths rose to an all-time high during the pandemic, according to the Centers for Disease Control and Prevention.

“We need to conduct more research to understand exactly why overdose deaths spiked during the pandemic,” Moric said. “It’s important to understand that our analysis measured the incidence of opioid abuse, and not the amount of consumption. It could be that while casual abuse declined, patients who tend to abuse opioids in higher amounts and more frequently used them at an even higher rate during the stress of the pandemic, increasing the rate of overdose deaths.”

This analysis opens the door for future research to focus on identifying possible risk factors for these groups that will lead the development of programs aimed at reducing opioid abuse, the researchers noted. It also provides care teams with important insights that can impact their approach to treating vulnerable patient populations.

“Clinicians need to be aware of the higher likelihood of recreational use of opioids among sexual minorities compared to non-LGBTQ populations,” Moric added. “With greater awareness of these disparities, we can foster a more compassionate understanding of these patients and provide the most appropriate care and education to address the issue and reduce the stigma.”

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