Trends in Use of Opioids for Chronic Noncancer Pain Among Individuals With Mental Health and Substance Use Disorders: The TROUP Study

作者：Mark J. Edlund, Bradley C. Martin, Andrea DeVries, Ming-Yu Fan, Jennifer Brennan Braden, Mark Daniel Sullivan · 发表于：Clinical Journal of Pain · 年份：2009 · DOI：10.1097/ajp.0b013e3181b99f35 · 被引用次数：272 · 研究领域：Opioid Use Disorder Treatment、Pain Management and Opioid Use、Musculoskeletal pain and rehabilitation

OBJECTIVES: Use of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear. These increases may be most marked in patients with mental health (MH) and substance use disorders (SUDs). We analyzed trends between 2000 and 2005 in opioid prescribing among individuals with noncancer pain conditions (NCPC), with and without MH and SUDs. METHODS: Secondary data analysis of longitudinal administrative data from 2 dissimilar populations: a national, commercially insured population and Arkansas Medicaid enrollees. We examined these opioid outcomes: (1) rates of any prescription opioid use in the past year, (2) rates of chronic use of prescription opioids (greater than 90 d in the past year), (3) mean days supply of opioids, (4) mean daily opioid dose in morphine equivalents, and (5) percentage of total opioid dose that was Schedule II opioids. RESULTS: In 2000, among individuals with NCPC, chronic opioid use was more common among those with a MH or SUD than among those without in commercially insured (8% vs. 3%, P<0.001) and Arkansas Medicaid (20% vs. 13%, P<0.001) populations. Between 2000 and 2005, in commercially insured, rates of chronic opioid use increased by 34.9% among individuals with an MH or SUD and 27.8% among individuals without these disorders. In Arkansas Medicaid chronic, opioid use increased by 55.4% among individuals with an MH or SUD and 39.8% among those without. DISCUSSION:...