OBJECTIVES: Veteran Health Administration has implemented polices to reduce prescription opioids since 2004 suggesting that rates of opioid use among Veterans may be lower than among non-Veterans. However, to date, no study has compared opioid use rates among elderly Veterans and non-Veterans. The objective was to estimate opioid use over time among elderly Veterans and compare them to elderly non-Veterans.

METHODS: A retrospective cross-sectional study was conducted using Medicare Current Beneficiary Survey (MCBS) data from 2001 through 2013 linked with fee-for-service Part A and Part B Medicare claims. We included elderly (age> RESULTS: Overall, opioid use was increased from 19.5% in 2001 to 24.6% in 2013 among elderly community-dwelling Medicare beneficiaries. Although rates of opioid use among Veterans were lower compared to non-Veterans in 2001 (15.3% vs 21.2%; 6 percentage point difference), the difference narrowed in 2013 (23.0% vs 25.3%; 2 percentage point difference). In multiple logistic regression models, with adjustments for age, sex, and pain conditions, there were no differences in the odds of opioid use between Veterans and non-Veterans (AOR=1.07, 95% CI=0.99–1.15; p=0.06).

CONCLUSIONS: Among all community-dwelling fee-for-service elderly Medicare beneficiaries, opioid use increased over time by 23% from 2001 to 2013. Although opioid use was lower among Veterans as compared to non-Veterans in 2001, there were no significant differences in opioid use between Veterans and non-Veterans by the end of 2013. These findings suggest all targeted efforts towards reducing the use of opioids can help both Veterans and non-Veterans enrolled in Medicare.