"When we look at the opioid crisis, most of the response has been to treat opioid overdose, making naloxone more available, for example. That's a good immediate intervention, but in the long run, we need to identify the underlying issues of the epidemic," said study author Janani Thapa, who studies chronic disease at UGA's College of Public Health.
When most health professionals talk about the risks of living with a chronic disease, opioid addiction doesn't make the list, but to Thapa, the association is obvious.
"Chronic disease is associated with pain. Pain is associated with opioid use," she said. "So, we thought, let's look at that and put some numbers behind the association."
One in four U.S. adults is living with at least one chronic disease, and many of these diseases are accompanied with chronic pain. Arthritis is one common example. Obesity is another.
That's why Thapa and her co-authors were particularly interested in the patterns of opioid-related hospitalizations among patients with conditions that were the most likely to be prescribed opioids, including asthma, arthritis, cancer, liver disease and stroke.
The researchers gathered inpatient data from a national sample of community hospitals, and they looked at the prevalence of chronic disease among patients who had been admitted for an opioid-related injury, from 2011 to 2015.
The results showed that over 90% of the opioid-related hospitalizations were among patients with two or more chronic diseases.
Thapa says the public health and health care fields need to be aware of the overlap between two of the country's growing epidemics and prioritize finding alternative, non-addictive strategies to managing the chronic pain.
"These aren't separate issues," said Thapa. "The numbers that we have make the case that hospitalization is happening because these patients are taking pain medications, and chronic disease is underlying many of these cases."
Thapa would like to see this study begin a conversation about allocating more of the resources pouring in to curb the opioid crisis toward chronic disease prevention.
"We are missing a key component, I think, if we aren't talking about preventing opioid misuse through chronic disease prevention," she said.