OBJECTIVES : To estimate opioid use prevalence and to identify the characteristics associated with opioid use among US older adults (≥50 years) with comorbid hypercholesterolemia and pain.

METHODS : This study used 2017 Medical Expenditure Panel Survey (MEPS) data and a retrospective, cross-sectional database design. Eligible study participants were aged 50 years or older, alive for the full calendar year, diagnosed with hypercholesterolemia, and reported having pain in the past four weeks. The dependent variable was opioid use status (opioid users versus non-users). Hierarchical logistic regression models identified significant predictors of opioid use. An alpha level of 0.05 was set a priori. National estimates were obtained by adjusting for the complex survey design of MEPS.

RESULTS : A total of 2,796 subjects were included in the study, of which 795 were opioid users and 2,001 were non-opioid users. The weighted total number of non-institutionalized adults alive aged 50 or older with hypercholesterolemia and pain in the US in 2017 was 28,483,745; of which 8,079,019 (28.4%, 95% confidence interval [CI]=26.3%, 30.4%) were opioid users. Several characteristics were significant predictors of opioid use, including: white versus other races (adjusted odds ratio [AOR]=1.782, 95% CI=1.350-2.351); Hispanic versus non-Hispanic ethnicity (AOR=0.452, 95% CI=0.320-0.640); 4 versus ≥5 chronic conditions (AOR=1.482, 95% CI=1.088-2.021); functional limitation versus no functional limitation (AOR=1.454, 95% CI=1.083-1.950); little/moderate versus quite a bit/extreme pain (AOR=0.443, 95% CI=0.343-0.573); good versus fair/poor perceived mental health status (AOR=1.477, 95% CI=1.038-2.101); smoker versus non-smoker (AOR=1.586, 95% CI=1.194-2.106); and Northeast versus West census region (AOR=0.560, 95% CI=0.383-0.817).

CONCLUSIONS : This study identified that approximately 8 million of the 28 million US older adults with hypercholesterolemia and pain used opioids in 2017. In addition, several characteristics of those individuals were predictors of opioid use, which could be important factors to address and help resolve the opioid epidemic.