Individuals with spinal cord injury have greater odds of substance use disorders than non-sci comparisons

Background: Individuals with spinal cord injury (SCI) are disproportionately affected by numerous physical and behavioral health disparities, but the literature lacks a clear understanding of the association between SCI and substance use disorders. Identifying such behavioral health disparities in persons with disabilities is an increasingly central focus for public health researchers and represents a critical first step for prevention. Method: The present study utilized a large database of deidentified electronic health records to examine the association between SCI and substance use disorders related to alcohol, cannabis, opioid, and nicotine. Examining data from patients 16 years or older who had patient encounters at the Penn State Hershey Medical Center from January 1, 1997 to April 30, 2018, the current study included data from 1,466,985 unique patients - 6192 of which held SCI diagnoses. Age-adjusted odds ratios were calculated using logistic regression. Results: Compared to non-SCI patients, individuals with SCI were at increased odds of having alcohol use disorder (OR: 4.19, 95% CI [3.67, 4.80]), cannabis use disorder (OR: 7.83, 95% CI [6.32, 9.69] ), opioid use disorder (OR: 7.97, 95% CI [6.59, 9.66]), and nicotine use disorder (OR: 4.66, 95% CI [4.40, 4.94]). Patient sex did not moderate any of the four associations. Conclusion: This study provides early indication that individuals with SCI may be disproportionately at-risk for substance use disorders and provides a foundation for future mechanistic and translational research. This evidence is a valuable step towards improving the health and quality of life for individuals with SCI.