Trends and Regional Variation in New Opioid Prescriptions and Long-Term Prescription Opioid Use Among Older Adults in the United States, 2012-2020

Speaker(s)

Bazzazzadehgan S1, Bhattacharya K2, Ramachandran S1, Bentley J3, Eriator I4, Yang Y2
1Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, University, MS, USA, 2Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, 3Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, USA, 4University of Mississippi Medical Center, Jackson, MS, USA

Presentation Documents

OBJECTIVES: Both new and long-term prescription opioid use have been decreasing in the US. This study aimed to provide updates on utilization and trends in new opioid prescriptions and long-term prescription opioid use among older adults enrolled in Medicare.

METHODS: This retrospective cohort study utilized 5% national Medicare claims data from 2012-2020. Medicare beneficiaries older than 65 who were enrolled in Medicare Parts A, B, and D for at least ten months in a year were included. Beneficiaries enrolled in Medicare Advantage plans were excluded from the study. Annual utilization and trends in new and long-term prescription opioid use episodes were measured over the study period.

RESULTS: Administrative claims of nearly 2.75 million older adult Medicare beneficiaries were analyzed. A majority of them were female (~56%) and White (~81%) with a mean age of about 75 years in each year. The proportion of all eligible beneficiaries with at least one new opioid prescription increased from 6.64% in 2013, peaked at 10.32% in 2015, and then steadily decreased to 5.37% in 2020. The proportion of individuals with long-term opioid use among those with a new opioid prescription decreased steadily from 12.40% in 2013 to 8.86% in 2019 and increased to 10.68% in 2020. Among new long-term opioid users, the proportion of beneficiaries with cancer during the study years fluctuated between 13.30%-15.60%, and the proportion with chronic non-cancer pain fluctuated between 28.99%-33.67%. Across all years, Southern states accounted for a large proportion of long-term opioid users increasing from 41.61% in 2013 to 55.73% in 2020.

CONCLUSIONS: Updated evidence supported that both new opioid use and long-term opioid use decreased among older adults in the last decade; however, regional variation in long-term opioid use exists, indicating differences in the approaches to manage chronic pain across geographic locations.

Code

EPH93

Topic

Epidemiology & Public Health, Study Approaches

Topic Subcategory

Public Health

Disease

Drugs, Oncology, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)