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Abstract
To examine the association of current and past Opiate Use Disorder (OUD) with measures
of HRQOL and employment in a nationally representative sample of adults. The 2012–2013
National Epidemiological Survey on Alcohol and Related Conditions III (NESARC III)
surveyed a nationally representative sample of non-institutionalized civilian adults
(≥18 years) in the US (n=36,309 unweighted). Using DSM-5 criteria, adults without
history of OUD were compared to those with current and past OUD. Using the SF-12 items,
standard measures of the mental and physical component scores of HRQOL and of quality-adjusted
life years (QALYs) were constructed. Employment in the past year (yes/no) was also
assessed. Multivariable-adjusted regression analyses were used to adjust for covariates.
Overall, 0.9% of the study sample, representing 2.1 of 235.4 million adults, met criteria
for current OUD; 1.2%, representing 2.7 million adults, met criteria for past OUD.
Adults with current or past OUD had large and moderately reduced mental component
(MCS) and physical health component (PCS) summary scores compared to adults who never
had OUD (p<0.001, respectively). Current OUD was associated with lower odds of being
employed compared to never experiencing OUD (Adjusted odds ratio=0.65; 95% CI: 0.48,
0.88; p=0.005), as was past OUD. Adjustment for potentially confounding factors reduced
the independent association of OUD and HRQOL by about 40–50% but did not change employment
comparisons. Adults with current OUD are associated with large reductions in HRQOL
and likelihood of not being employed, and adults with past OUD also have considerable
residual impairment.