Prevalence and distribution of high‐risk prescription opioid use in the United States, 2011–2016. Issue 11 (6th September 2021)

• Record Type: Journal Article
• Authors: McCormick, Carter D.; Dadiomov, David; Trotzky‐Sirr, Rebecca; Qato, Dima M.
• Is Part Of: Pharmacoepidemiology and drug safety. Volume 30:Issue 11(2021)
• Page Start: 1532
• Page End: 1540
• Publication Date: 2021-09-06
• Subjects: high‐risk opioid use -- opioid utilization trends -- pharmacy dispensing data -- prescription opioids -- United States opioid use; Pharmacoepidemiology -- Periodicals; Chemotherapy -- Periodicals; Epidemiology -- Periodicals; 615.705
• DOI: 10.1002/pds.5349
• Languages: English
• ISSNs: 1053-8569

Abstract

Abstract: Purpose: Despite the efforts of many stakeholders to reduce the risk of opioid overdose, there is limited information on the prevalence of high‐risk prescription opioid use in the US. Methods: Descriptive analysis of a nationally representative 5% random sample of anonymized, longitudinal, individual‐level prescription claims from IQVIA LRx between January 1, 2011 and December 31, 2016 among individuals ages 18 years or older that used a retail pharmacy. High‐risk opioid use was defined as ≥50 morphine milligram equivalents per day and/or having concurrent dispensing of a benzodiazepine based on overlapping days of coverage. Results: The prevalence of high‐risk opioid use among adults in the US decreased from 12.0% in 2011 to 9.4% in 2016 ( p < 0.01). Declines were most pronounced among individuals ages 18–35 years (10.9%–7.0%, 36.2% decline; p < 0.01) compared to individuals age 65 years or greater (10.5%–9.8%, 6.7% decline; p < 0.01). Declines in high‐risk use prevalence were observed across 49 states, with only South Dakota experiencing an increase (+13.7% relative increase). Similar to earlier years, in 2016 50.9% of all high‐risk use opioid users received all their opioid prescriptions from a single prescriber, and 71.1% used a single pharmacy to fill them. Conclusion: Despite clinically significant declines in high‐risk opioid use, in 2016 nearly 1 in 10 adult retail pharmacy users remained at high‐risk for opioid overdose in the US. Future clinical and policy interventions should consider targeting older adults with Medicare Part‐D, including those using a single pharmacy to fill their opioid prescriptions.