Annual Prevalence of Opioid Receipt by South Carolina Medicaid-Enrolled Children and Adolescents: 2000-2020

Abstract

Understanding patterns of opioid receipt by children and adolescents over time and understanding differences between age groups can help identify opportunities for future opioid stewardship. We conducted a retrospective cohort study, using South Carolina Medicaid data for children and adolescents 0-18 years old between 2000-2020, calculating the annual prevalence of opioid receipt for medical diagnoses in ambulatory settings. We examined differences in prevalence by calendar year, race/ethnicity, and by age group. The annual prevalence of opioid receipt for medical diagnoses changed significantly over the years studied, from 187.5 per 1000 in 2000 to 41.9 per 1000 in 2020 (Cochran-Armitage test for trend, p < 0.0001). In all calendar years, older ages were associated with greater prevalence of opioid receipt. Adjusted analyses (logistic regression) assessed calendar year differences in opioid receipt, controlling for age group, sex, and race/ethnicity. In the adjusted analyses, calendar year was inversely associated with opioid receipt (aOR 0.927, 95% CI 0.926-0.927). Males and older ages were more likely to receive opioids, while persons of Black race and Hispanic ethnicity had lower odds of receiving opioids. While opioid receipt declined among all age groups during 2000-2020, adolescents 12-18 had persistently higher annual prevalence of opioid receipt when compared to younger age groups.

Keywords: Medicaid; adolescents; children; ethnicity; opioid; patient safety; prevalence; race.

Figure 1

Annual Prevalence^a of Opioid Receipt per 1000 Persons, South Carolina Medicaid Enrollees 0–18 years old, by Age Group, 2000–2020. Annual prevalence calculation: numerator = number of persons within age category who received ≥1 opioid in a calendar year; denominator = number of persons who received ≥1 medication of any type in the same calendar year, expressed per 1000 enrollees. An enrollee may appear in multiple years.

Figure 2

Annual Prevalence^a of Opioid Receipt per 1000 Persons, South Carolina Medicaid Enrollees 0–18 years old, by Calendar year and 1-Year Age Strata, 2000–2020. Annual prevalence calculation: numerator = number of persons within age category who received ≥1 opioid in a calendar year; denominator = number of persons who received ≥1 medication of any type in the same calendar year, expressed per 1000 enrollees. An enrollee may appear in multiple years.