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Physical disability sometimes co-occurs with chronic pain but may also represent an independent risk factor for opioid misuse. However, previous research has not disentangled whether disability contributes to risk independent of chronic pain.<\/jats:p><\/jats:sec><jats:sec id=\"S003329172300332X_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Here, we estimate the independent and joint adjusted associations between having a physical disability and co-occurring chronic pain condition at time of Medicaid enrollment on subsequent 18-month risk of incident opioid use disorder (OUD) and non-fatal, unintentional opioid overdose among non-elderly, adult Medicaid beneficiaries (2016\u20132019).<\/jats:p><\/jats:sec><jats:sec id=\"S003329172300332X_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>We find robust evidence that having a physical disability approximately doubles the risk of incident OUD or opioid overdose, and physical disability co-occurring with chronic pain increases the risks approximately sixfold as compared to having neither chronic pain nor disability. In absolute numbers, those with neither a physical disability nor chronic pain condition have a 1.8% adjusted risk of incident OUD over 18 months of follow-up, those with physical disability alone have an 2.9% incident risk, those with chronic pain alone have a 3.6% incident risk, and those with co-occurring physical disability and chronic pain have a 11.1% incident risk.<\/jats:p><\/jats:sec><jats:sec id=\"S003329172300332X_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest that those with a physical disability should receive increased attention from the medical and healthcare communities to reduce their risk of opioid misuse and attendant negative outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s003329172300332x","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T08:04:44Z","timestamp":1700208284000},"page":"1419-1430","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Independent and joint contributions of physical disability and chronic pain to incident opioid use disorder and opioid overdose among Medicaid patients"],"prefix":"10.1017","volume":"54","author":[{"given":"Katherine L.","family":"Hoffman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriana","family":"Milazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas T.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Samples","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Olfson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Diaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Doan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Cerda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Crystal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9417-7960","authenticated-orcid":false,"given":"Kara E.","family":"Rudolph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"S003329172300332X_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/pam.21618"},{"key":"S003329172300332X_ref20","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1257\/jep.20.3.71","article-title":"The growth in the social security disability rolls: A fiscal crisis unfolding","volume":"20","author":"David","year":"2006","journal-title":"Journal of Economic Perspectives"},{"key":"S003329172300332X_ref47","unstructured":"Kaiser Family Foundation. 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