Breaking News
March 18, 2019 - Taking painkillers during pregnancy is not responsible for asthma risk in children, study shows
March 18, 2019 - Prediagnosis Psychiatric Care Linked to Worse Cancer Mortality
March 18, 2019 - Paris hospital halts stool study after donor deluge
March 18, 2019 - Partial oral antibiotic therapy shows efficacy and safety in patients with infectious endocarditis
March 18, 2019 - Olympus improves access to science education through BioBus collaboration
March 18, 2019 - Depression screening does not improve quality of life in heart attack patients
March 18, 2019 - Echocardiography may aid in patient selection for TMVR
March 18, 2019 - Are ‘Inactive’ Ingredients in Your Drugs Really So Harmless?
March 18, 2019 - Scientists tackle rare retinal disease in unique research project
March 18, 2019 - Death By A Thousand Clicks
March 18, 2019 - Absorbable, antibiotic-eluting envelope can reduce rate of cardiac device infections
March 18, 2019 - Hormonal treatment associated with depression in men with prostate cancer
March 18, 2019 - Porvair Sciences launches reinforced 96-well deep round microplate
March 18, 2019 - Simplified catheter ablation could slash waiting lists for atrial fibrillation patients
March 18, 2019 - BFR therapy as part of rehabilitation following ACL surgery may slow bone loss
March 18, 2019 - A human model to test implants for cataract surgery
March 18, 2019 - New risk adjustment model could reduce financial penalty for safety net hospitals
March 18, 2019 - NHS cancer patients’ wait to start treatment worrying
March 18, 2019 - Inventiva Announces Results from Phase IIb Clinical Trial with Lanifibranor in Systemic Sclerosis
March 18, 2019 - Cologuard
March 18, 2019 - Researchers find evidence of prenatal environment tuning genomic imprinting
March 18, 2019 - Dolomite Bio launches novel Nadia product family for single-cell research
March 18, 2019 - Intellipharmaceutics Announces Resubmission of New Drug Application to the U.S. FDA for its Oxycodone ER
March 18, 2019 - Excessive gestational weight gain tied to maternal morbidity
March 18, 2019 - RCEM issues position statement on metrics to supplement four-hour standard target
March 17, 2019 - Noncontrast Brain MRI Effective for Monitoring Multiple Sclerosis
March 17, 2019 - Brain region plays key role in regulation of parenting behavior, study finds
March 17, 2019 - Natural speed limit on DNA replication sets pace for life’s first steps
March 17, 2019 - New research reveals overlooked impact of herbicide glyphosate on the environment
March 17, 2019 - Molecular patterns could help predict relapse risk in breast cancer patients
March 17, 2019 - Study confirms sensitivity of microbiological cultures for detecting cholera
March 17, 2019 - Scientists Spot Clues to Predicting Breast Cancer’s Return
March 17, 2019 - Scientists identify gene that keeps PTSD-like behavior at bay in female mice
March 17, 2019 - New method would allow doctors to detect earliest stages of cancers in the lymph nodes
March 17, 2019 - Cholesterol protein discovery raises hope for smarter drugs
March 17, 2019 - New insect medium delivers high viable cell density growth and protein yield
March 17, 2019 - Opioid crisis brings concerns about heart dangers
March 17, 2019 - Resistance Training May Prevent Type 2 Diabetes Progression
March 17, 2019 - Bioluminescence sensors make new approaches to drug discovery possible
March 17, 2019 - New FDA Rules Aim to Keep Kids From Flavored E-Cigarettes
March 17, 2019 - Vitamin B3 analogue boosts production of blood cells
March 17, 2019 - Government cuts to stop smoking services have detrimental impact on public health
March 17, 2019 - Common tool to assess potential adoptive parents lags behind societal changes
March 17, 2019 - Patients’ own cells could be the key to treating Crohn’s disease
March 17, 2019 - Diagnostic delays common in inflammatory bowel disease
March 17, 2019 - Study uncovers dramatic differences in the brains of Hispanics with dementia
March 17, 2019 - Study describes epigenetic loss that changes how cells obtain energy from cancer
March 16, 2019 - Active Bathing in Non-ICU Setting Does Not Cut Infections
March 16, 2019 - How the immune system maintains a healthy gut microbiota
March 16, 2019 - Bacteria ‘trap’ could help in the fight against antimicrobial resistance
March 16, 2019 - Hospital work environment associated with all EHR usability outcomes
March 16, 2019 - Study unravels mystery behind how the brain encodes time when forming long-term memories
March 16, 2019 - Light physical activity may lower risk of cardiovascular disease in older women
March 16, 2019 - USP15 enzyme could potentially lead to new treatments for breast, pancreatic cancer
March 16, 2019 - After Chinese Infant Gene-Editing Scandal, U.S. Health Officials Join Call for a Ban
March 16, 2019 - PACS1 syndrome – Genetics Home Reference
March 16, 2019 - Researchers discover an unexpected organization of antimicrobial molecules that amplifies immune response
March 16, 2019 - With New Study, Era of Open-Heart Surgery for Aortic Stenosis May be Ending
March 16, 2019 - Dolomite Bio introduces high throughput sNuc-Seq protocol for its Nadia Instrument
March 16, 2019 - New course prepares materials scientists for biomedical testing
March 16, 2019 - Finding clues to a functional HIV cure
March 16, 2019 - People with chronic periodontitis have higher risk for dementia
March 16, 2019 - Few heart care recommendations are based on rigorous study
March 16, 2019 - Colorectal cancer diagnosed at early age is distinct from that in older patients
March 16, 2019 - Researchers use MRI and AI techniques at birth to predict cognitive development at age 2
March 16, 2019 - Discarding information from the brain linked to more mental effort, finds study
March 16, 2019 - OTA International supplement provides current snapshot and forward look at global trauma systems
March 16, 2019 - NIH trial to track outcomes of liver transplantation from HIV+ donors to HIV+ recipients
March 16, 2019 - Apple Heart Study shows how wearable technology can help detect heart problem
March 16, 2019 - Researchers determine factors that cause stress development in the human body
March 16, 2019 - Elderly Men Undertreated for Osteoporosis
March 16, 2019 - People with chronic pain are coping with the help of Pinterest, new study reveals
March 16, 2019 - New study could reveal the complex interaction between languages and human beings who use them
March 16, 2019 - Tufts engineers develop new tool to identify metabolic signatures linked to disease
March 16, 2019 - New proteomics-based test could aid in early detection of ovarian cancer
March 16, 2019 - New research opens possibility of using sperm taken from testicles to overcome infertility
March 16, 2019 - Scientists find new proof that narcolepsy is an autoimmune disease
March 16, 2019 - FDA OKs a New Generic of the Blood Pressure Drug Valsartan to Ease Shortage Due to Recalls
March 16, 2019 - Eliminating smoking and obesity could affect racial health disparities
March 16, 2019 - Wearable tracking device achieves higher accuracy in position tracking using thermal sensors
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