Neighborhood characteristics and opioid use disorder among older Medicare beneficiaries: An examination of the role of the COVID-19 pandemic

This study investigates how the associations between residential characteristics and the risk of opioid user dis-order (OUD) among older Medicare beneficiaries (age >= 65) are altered by the COVID-19 pandemic. Applying matching techniques and multilevel modeling to the Medicare fee-for-service claims data, this study finds that county-level social isolation, concentrated disadvantage, and residential stability are significantly associated with OUD among older adults (N =1,080,350) and that those living in counties with low levels of social isolation and residential stability experienced a heightened risk of OUD during the pandemic. The results suggest that the COVID-19 pandemic has aggravated the impacts of residential features on OUD.