OBJECTIVE: The purpose of this study was to evaluate prescribing of opioid analgesics for the treatment of non-malignant pain conditions. METHODS: The 1995 MarketScan? database was used to identify patients without malignant diagnoses and at least one prescription for an opioid. The resulting cohort was classified into three mutually exclusive categories: transdermal fentanyl (TDF n=118), long-acting opioids (LA n=136), and short-acting opioids (SA n=92,412). Demographics, diagnosis categories, and resource utilization (outpatient, inpatient, and prescription claims) were examined. RESULTS: The number of patients in the SA group was disproportionately larger than the other groups preventing a direct comparison. Their average age was 40 years, primarily female, and 71% working full time. The most common diagnosis category was musculoskeletal (MSK) and lumbago was the most frequent condition. For comparative purposes, we examined diagnoses groups and resource utilization for the TDF and LA groups. Age, gender and employment status was similar for both groups. The MSK category and lumbago diagnoses were also the most common conditions. TDF patients had more lumbago physician visits but less cost/patient compared to the LA group (median 6 visits, $49.50 vs. 2.5 visits, $74.50, respectively). Inpatient use was similar between groups with a median of 2 occurrences/patient. The median prescription use/patient of TDF was slightly less than LA (3 vs. 4.5) and both groups used a similar number of other opioid analgesics (median=13). CONCLUSION: This study suggests a similar distribution of conditions associated with the use of TDF, LA, and SA opioids. However, SA opioid utilization in non-malignant pain differs from TDF and LA agents. Further analysis is necessary to identify characteristics that differentiate these groups.