Date of Conferral

7-21-2026

Date of Award

July 2026

Degree

Ph.D.

School

Health Sciences

Advisor

Dr. Heba Tawfik

Abstract

Opioid prescribing rates and opioid misuse remain high throughout the United States. Exposure to opioids has been positively associated with various cancers; however, research evaluating associations between opioid exposure and hematologic cancers like leukemia and lymphoma is limited. Using the Socio- Ecological Model as a foundation, this quantitative cross-sectional study aimed to analyze the association between medicinal opioid use, opioid misuse, and leukemia/lymphoma while exploring how selected social determinants of health (SDOH) may modify that relationship. Secondary data were pooled from the 2015–20-year United States National Survey on Drug Use and Health (NSDUH). One thousand three hundred and twenty binary logistic regression models were used to calculate crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) while controlling for age and gender. Combined opioid exposure as well as individual opioid medications were analyzed. Combined medicinal opioid use and combined opioid misuse were not associated with leukemia/lymphoma after adjustment. Hydromorphone use remained significantly associated with leukemia/lymphoma (AOR = 1.84, 95% CI [1.32, 2.55]). Selected SDOH variables did not substantively alter opioid effect estimates. Findings from this study may facilitate positive social change by solidifying the body of evidence regarding opioid exposure and leukemia/lymphoma. Furthermore, results can help guide future research by preventing unnecessary hypothesizing, overinterpretation of results, and prioritization of investigation of specific opioids or populations.

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