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Multicenter Study
. 2008 Nov;9(11):1026-35.
doi: 10.1016/j.jpain.2008.06.002. Epub 2008 Jul 26.

Trends in use of opioids by noncancer pain type 2000-2005 among Arkansas Medicaid and HealthCore enrollees: results from the TROUP study

Jennifer Brennan Braden  1 , Ming-Yu Fan, Mark J Edlund, Bradley C Martin, Andrea DeVries, Mark D Sullivan
Affiliations
Multicenter Study

Trends in use of opioids by noncancer pain type 2000-2005 among Arkansas Medicaid and HealthCore enrollees: results from the TROUP study

Jennifer Brennan Braden et al. J Pain. 2008 Nov.

Abstract

Use of prescription opioids for noncancer pain has increased significantly in recent years, but it is not known if trends differ among the most common noncancer pain conditions. We examined trends in opioid prescribing for the years 2000 through 2005 for individuals with arthritis/joint pain, back pain, neck pain, and headaches by type and number of pain diagnoses, using data from claims records from 2 health insurers: HealthCore commercially insured members (N = 3,768,223) and Arkansas Medicaid (N = 127,866). Rates of headache, back pain, and neck pain diagnoses increased significantly in Arkansas Medicaid enrollees but more modestly among HealthCore enrollees. Rates of opioid use increased in both groups, with long-term use (>90 days' supply per year) increasing at twice the rate of any use. Rates of opioid use did not differ widely between noncancer pain conditions, but long-term opioid use rates doubled with each additional pain diagnosis. Mean days supply and cumulative yearly dose increased between 2000 and 2005 for all pain types and with increasing number of pain diagnoses, but dose per day supply remained relatively stable. The greatest increases in dose among all the pain conditions were seen in short-acting DEA Schedule II opioids.

Perspective: This study demonstrates increased use of opioids, particularly long-term use, in noncancer pain over a 6-year period among those with multiple pain types. These results appear to reflect a general increase in use of prescription opioids for noncancer pain rather than a condition-specific change in prescribing practices.

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Figures

Figure 1
Figure 1
a: Number and Type of Chronic Non-Cancer Pain Diagnoses among HealthCore Enrollees Receiving Opioids in 2005 b: Number and Type of Chronic Non-Cancer Pain Diagnoses among Arkansas Medicaid Enrollees Receiving Opioids in 2005
Figure 1
Figure 1
a: Number and Type of Chronic Non-Cancer Pain Diagnoses among HealthCore Enrollees Receiving Opioids in 2005 b: Number and Type of Chronic Non-Cancer Pain Diagnoses among Arkansas Medicaid Enrollees Receiving Opioids in 2005
Figure 2
Figure 2
a: Trends in Mean Cumulative Yearly Opioid Dose by Number of Pain Types, HealthCore 2000-2005 b: Trends in Mean Cumulative Yearly Opioid Dose by Number of Pain Types, Arkansas Medicaid 2000-2005
Figure 2
Figure 2
a: Trends in Mean Cumulative Yearly Opioid Dose by Number of Pain Types, HealthCore 2000-2005 b: Trends in Mean Cumulative Yearly Opioid Dose by Number of Pain Types, Arkansas Medicaid 2000-2005
See this image and copyright information in PMC

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