OBJECTIVES To describe the prevalence of outpatient prescription opiate use among patients with Commercial, Medicare Supplemental , or Medicaid insurance in the US after 2010.   METHODS Patients were identified using the Truven Health Commercial and Medicare Supplemental databases from 2010-2013 and Medicaid Multi-State databases from 2010-2012. We estimated the proportion of patients with at least one outpatient opiate prescription for each calendar year among patients with continuous medical and pharmacy enrollment for the entire calendar year, stratified by insurance type and age (<18, 18-64, 65+). Average opiate days supply per calendar year was also described.   RESULTS On average, a total of 32.9 million (m) patients were included in each calendar year analysis with an average of 6.7m Commercially-insured children, 20.2m Commercially-insured non-elderly adults, 2.5m Medicare Supplemental adults (age 65+), 2.6m Medicaid-insured children and 0.8m Medicaid-insured adults per year.  Among commercially-insured non-elderly adults, the prevalence of opiate prescriptions decreased from 25.1% to 23.4% from 2010 to 2013 (p<0.001) with a similar decrease among Medicare Supplemental patients (29.5% to 27.6%, p<0.001).  Among Medicaid adults, opiate prescription prevalence was lower prevalence in 2012 (38.9%) than in 2010 (44.1%) or 2011 (45.2%).  Among children (age <18), opiate prescription prevalence use was slightly higher for Medicaid than commercially-insured children (9.9% versus 7.4%, p<0.001); opiate prescription prevalence dropped by 15.3% among commercially-insured patients from 2010 to 2013 (p<0.001) and by 12.1% among Medicaid children from 2010 to 2012 (p<0.001).  Average annual days supply increased over time among Medicaid adults (92.8 to 100.5 days), commercially-insured non-elderly adults (41.7 to 44.5 days) and Medicare Supplemental adults (65.9 to 68.6 days); days supply per year was steady among children (calendar year range: 7.5-9.1).   CONCLUSIONS There were modest reductions in the prevalence of prescription opiate use from 2010-2013. Further and more detailed monitoring is needed to parallel efforts to curtail inappropriate use.