Breaking News
March 27, 2019 - Managing MS
March 27, 2019 - Researchers reveal how receptor TLR-9 protects against lupus
March 27, 2019 - Doctors share story of daughter’s treatment for leukemia
March 27, 2019 - Medical Center Hosts Networking Session for Women’s History Month
March 27, 2019 - Positive link found between anxiety during childhood, adolescence with later alcohol use disorders
March 27, 2019 - Coronary artery calcium indicates patients’ imminent risk of a heart attack
March 27, 2019 - Luxia Scientific partners with Life Genomics to commercialize microbiome-based tests in the Nordic countries
March 26, 2019 - New mathematical algorithm objectively classifies shapes of neurons in the brain
March 26, 2019 - Research suggests oxytocin as potential new obesity treatment
March 26, 2019 - Education may not protect against dementia as previously thought
March 26, 2019 - Stanford acquires archive of palliative care pioneer Elisabeth Kübler-Ross | News Center
March 26, 2019 - New research aims to turn worms against parasite-associated cancer
March 26, 2019 - Psychological evolution may help explain differences between male and female serial killers
March 26, 2019 - New molecular mechanism involved in pancreas repair identified
March 26, 2019 - Obesity linked to reproductive problems in women with type 1 diabetes
March 26, 2019 - New short-pulse ultrasound technique enhances drug delivery to brains of mice
March 26, 2019 - Researchers uncover mechanism that initiates sexual organs maturation
March 26, 2019 - DermBiont Begins Phase 2 Clinical Trial for Athlete’s Foot with a Live Bacterial Topical Probiotic
March 26, 2019 - Persons with Alzheimer’s disease have a higher risk of head injuries
March 26, 2019 - Mental health issues associated with income inequalities in Indigenous people
March 26, 2019 - Participation in sports linked with fewer depressive symptoms in children
March 26, 2019 - Brain process common to sleep and aging discovered
March 26, 2019 - People under age 50 with hearing loss more likely to misuse alcohol and drugs
March 26, 2019 - People with and without cancer use different dosages of cannabis formulations, study shows
March 26, 2019 - Young people at risk of addiction show differences in key brain region
March 26, 2019 - In virtual exchange, students in California and Lebanon unite to improve refugee health
March 26, 2019 - Trump Administration Changes Course, Asks Court To Strike Down ACA
March 26, 2019 - People with untreated diabetes develop signs of Alzheimer’s disease at a faster rate
March 26, 2019 - Study explains how bright colors evolved and diversified in male guppies
March 26, 2019 - Savings from lower insurance costs of growth hormone drugs not passed on to patients
March 26, 2019 - Study highlights the need to pay more attention on specific nutritional needs of female athletes
March 26, 2019 - Sleep quality varies throughout menstrual cycle in young women
March 26, 2019 - A1c diabetes blood test found to be unreliable
March 26, 2019 - Younger Female Blood Donors Vulnerable to Iron Deficiency
March 26, 2019 - Prostate cancer cells ‘spit out’ a protein that promotes tumor growth
March 26, 2019 - Finding the elusive drinking ‘brake’
March 26, 2019 - Using the Mastermind strategy in brain research
March 26, 2019 - Symptomatic pharmacotherapy of elderly people should be regularly monitored
March 26, 2019 - Synthetic biological logic gate could one day be used to modify cellular function
March 26, 2019 - Damage to anxiety-associated brain region heightens monkeys’ defensive response
March 26, 2019 - Researchers uncover large-scale brain patterns and networks which control sleep
March 26, 2019 - Scientific Symposium at LABVOLUTION focuses on key issues in life sciences
March 26, 2019 - Screen time plus snacking could increase risk for metabolic syndrome in teens
March 26, 2019 - Attention, Seniors: Drink More Water and Head Off Disease
March 26, 2019 - Peptide shows promise for protecting kidneys from nephritis
March 26, 2019 - Causes of diabetes decline or disappear when ‘zombie cells’ are removed, shows study
March 26, 2019 - Scientists identify common genetic variants associated with post-stroke recovery
March 26, 2019 - Study finds link between menopause and changes in body composition
March 26, 2019 - Higher levels of sex hormones in older men related to lower biological age
March 26, 2019 - Research links participation in team sports to larger hippocampal volumes in children
March 26, 2019 - Cerveau announces research collaboration agreement with Eisai for novel tau imaging agent
March 26, 2019 - New technique measures frequency of sounds emitted from biological structures
March 26, 2019 - Removal of ‘zombie cells’ alleviates causes of diabetes in obese mice
March 26, 2019 - Women exposed to deepwater horizon oil spill continue to experience PTSD symptoms
March 26, 2019 - Shaping new treatments for tuberculosis
March 26, 2019 - Understanding genetic interactions holds key to new personalized therapies
March 26, 2019 - Nervous system relies on guidance cues for neuronal axons to reach destinations
March 26, 2019 - Altering gut microbiome may be potential treatment option for PCOS
March 26, 2019 - Moleculin Files with FDA for Expedited Approval Pathway for Annamycin
March 26, 2019 - GPs play pivotal role in ensuring success of new Faster Diagnosis Standard for Cancer
March 26, 2019 - New clues discovered to lung transplant rejection
March 26, 2019 - New study offers insight into development of delusions
March 26, 2019 - Children’s ball pits full of pathogenic microbes
March 26, 2019 - Exploring pathophysiological factors that link sleep problems and Alzheimer’s disease
March 26, 2019 - Walking downhill after meals can reduce bone resorption in postmenopausal women with diabetes
March 26, 2019 - USA LESS Issues Voluntary Nationwide Recall of LEOPARD Miracle Honey Due to Presence of Undeclared Sildenafil
March 26, 2019 - CT scan prior to spine fusion finds almost half of patients had undiagnosed osteoporosis
March 26, 2019 - After 2 Apparent Student Suicides, Parkland Grieves Again
March 25, 2019 - Inherited form of rickets improves more with new injectable medicine than conventional therapy
March 25, 2019 - Trastuzumab Tied to Higher Long-Term Risk for Heart Failure
March 25, 2019 - Personal context directly affects CPAP use
March 25, 2019 - Mosquito tracking key to preventing disease outbreaks
March 25, 2019 - Scientists Detect Hidden Signals from Beneficial Bacteria
March 25, 2019 - Treating women with thyroid antibodies with Levothyroxine do not increase live birth rate
March 25, 2019 - Brain area that only processes spoken, not written words identified
March 25, 2019 - Race and ethnicity influence fracture risk in diabetic patients
March 25, 2019 - Researchers report new regenerative medicine approach for treating osteoarthritis of the knee
March 25, 2019 - Exposure to dim light at night may contribute to spread of breast cancer to bones
March 25, 2019 - Benefits of osteoporosis treatment in postmenopausal women outweigh the perceived risks
March 25, 2019 - Researchers find evidence of Cryptosporidium parasite in Minnesota’s public water systems
US opioid use not declined, despite focus on abuse and awareness of risk

US opioid use not declined, despite focus on abuse and awareness of risk

image_pdfDownload PDFimage_print
Credit: CC0 Public Domain

Use of prescription opioids in the United States has not substantially declined over the last decade, despite increased attention to opioid abuse and awareness of their risks, finds a study published by The BMJ today.

The results show that, although opioid use and average dose of opioids levelled off after a peak in 2012-13, all patient groups had a higher average daily dose in 2017 than in 2007, and use was particularly high among patients with a disability.

The US has the highest rate of opioid use in the world, consuming seven times more prescription opioids per person than the UK. An average of 40 people die in the US every day from prescription opioid overdose, and opioid use has been declared a public health emergency.

Recent studies have focused on the sale and supply of opioids, but information on patient demographics is limited. As a result, relatively little is known about opioid use among people outside of the government-provided Medicare insurance scheme.

So a team of US based researchers used data from a national database of medical and pharmacy claims to examine trends in opioid use among 48 million people with health insurance at any time between 2007 to 2016.

Participants were covered either by commercial (private) insurance, or by Medicare Advantage (cover offered by private insurers on behalf of Medicare).

The majority of non-elderly people in the US are covered by commercial insurance, often through their employer or a family member’s employer. Most US citizens aged 65 and older are eligible for Medicare, while others are eligible owing to permanent disability.

The research team took certain information into account, such as age, sex and place of residence, race or ethnicity, and type of medical coverage.

To allow for comparison of doses across different drugs they used conversion factors from the Centers for Disease Control and Prevention to translate prescriptions of each drug into milligram morphine equivalents (MME).

The researchers found that although the rate of opioid use and average dose of opioids levelled off after a peak in 2012-13, all three insurance groups had a higher average MME dose in 2017 than in 2007.

Disabled Medicare beneficiaries were much more likely to use opioids than others. They were also more likely to take higher daily doses over a longer period of time.

For example, they found that 52% of disabled Medicare beneficiaries used opioids annually, compared with 14% of commercially insured people and 26% of aged Medicare Advantage beneficiaries.

Disabled Medicare beneficiaries aged 45 to 54 had the highest rate of opioid use. In the third quarter of 2012, 45% of disabled Medicare beneficiaries aged 45 to 54 used opioids.

They also report that within the commercially insured group, by far the most commonly dispensed drug was hydrocodone, but in terms of volume, oxycodone and hydrocodone were similar.

During the study period, the average daily observed dose for disabled Medicare beneficiaries using opioids never dropped below 50 MME per day, a level at which odds of overdose are up to four times higher than with doses of less than 20 MME per day.

The researchers point out that this is an observational study so cannot establish cause, and they outline some limitations. For example, the study did not capture all groups of people, including uninsured people, and claims data may have missed prescriptions for people with multiple sources of insurance.

Nevertheless, they say their results make clear that opioid use rates are high in the US compared with other countries.

And they suggest that doctors and patients should consider whether long term opioid use is improving the patient’s ability to function, and if not, should consider other treatments either as an addition or replacement to opioid use.


Explore further:
New rules may constrain docs’ ability to treat chronic pain

More information:
Trends in opioid use in commercially insured and Medicare Advantage populations in 2007-16: retrospective cohort study, The BMJ, www.bmj.com/content/362/bmj.K2833

Journal reference:
British Medical Journal (BMJ)

Provided by:
British Medical Journal

Tagged with:

About author

Related Articles