Trends in Opioid Use among Social Security Disability Insurance Applicants

Several factors suggest that opioid use may be common among applicants to Social Security Disability Insurance (SSDI): the prevalence of opioid use, the suspected link between opioid use and declining rates of work, and the large share of new SSDI awardees who have conditions associated with opioid use. However, research-ready data on opioid use by these applicants, who are generally not eligible for Medicare, have not been available. SSDI applicants are required to report their medications, but they often do so in an open-ended text field, which requires additional coding before analysis.

Our study is the first to provide statistics on opioid use among SSDI applicants. We used an innovative machine-learning method to identify opioids in medication text fields in SSDI administrative data. Specifically, we examined the prevalence of reported opioid use in a 30 percent random sample of initial-level SSDI applications stored in the Social Security Administration’s Structured Data Repository (SDR) from 2007 through 2017, considering differences by demographic and other factors. We supplemented the SDR with two SSA administrative data sources: the Disability Analysis File, which provided award information, and the Numerical Identification System, which provided information on deaths. Using these sources, we produced statistics on the association between (1) opioid use among SSDI applicants and (2) SSDI award and death. Understanding the prevalence of reported opioid use among these individuals and the association between opioid use and later SSDI application outcomes may help in forecasting the future composition of the SSDI caseload.