LAUSR

The availability of prescription opioids is a key factor in the opioid epidemic, where their misuse can lead to opioid use disorder (OUD). Compared with the general population, persons with disabilities are prescribed medications more frequently and may be more likely to misuse prescriptions. Temporarily disabled workers may experience longer periods of disability in areas with longer-term opioid prescribing. Recipients of social security disability insurance (SSDI) are more likely to have an opioid prescription than the general population. Among other factors, increased access to health insurance accompanying disability benefits could make recipients more vulnerable to overprescribing of opioids, which in turn could lead to greater incidence of OUD and opioid-related deaths. 6 This study quantifies how the cumulative county-level change in opioid prescribing is explained by the change in receipt of SSDI and supplemental security income (SSI). SSDI and SSI differ substantively in their benefit structures and their beneficiary populations. For example, SSDI recipients are eligible for Medicare and SSI recipients are eligible for Medicaid. SSDI income is based on earned benefits through employment, while SSI income targets eligible low-income individuals. The study focuses on two periods before and after the national peak in opioid prescribing (2006–2012, 2012–2017).