Concomitant use of prescription opioids and psychotropic medications: analysis of Mississippi Medicaid members
- PMID: 41369005
- DOI: 10.1080/17581869.2025.2599727
Concomitant use of prescription opioids and psychotropic medications: analysis of Mississippi Medicaid members
Abstract
Objectives: To estimate the prevalence and intensity of concomitant opioid and psychotropic medication use in Mississippi Medicaid members.
Methods: This cross-sectional study used Mississippi Medicaid claims from 2016 to 2021 and examined members who filled at least one opioid prescription in a given year. The prevalence and intensity of concomitant opioid-psychotropic use, along with demographic characteristics, chronic non-cancer pain (CNCP) diagnoses, mental health diagnoses, and long-term opioid therapy (LTOT) among members were estimated annually.
Results: The eligible sample declined from 82,550 in 2016 to 51,583 in 2021, with CNCP diagnoses at 21% to 24% and LTOT use at 16% to 9%. Concomitant use prevalence was 33.3% in 2016 and 33.8% in 2021, with antidepressants (range: 14.46%-17.04%) and muscle relaxants (range: 13.92%-15.49%) being the most commonly used concomitant medications. Concomitant benzodiazepine use decreased over time (from 9.42% to 3.04%). Concomitant use intensity increased from 76.7% in 2016 to 84.3% in 2021, with mean increases for all studied medications.
Conclusions: Despite reductions in opioid use, the stable prevalence and rising intensity of psychotropic medication overlap highlight a growing reliance on multimodal pharmacologic approaches. These findings underscore the importance of coordinated prescribing, ongoing monitoring, and targeted interventions to mitigate risks in vulnerable populations.
Keywords: Medicaid; Mississippi; Opioids; opioid-related disorders; pain management; practice patterns; prevalence; psychotropic drugs.
Plain language summary
What is this article about?This article looks at how often and how intensely people in Mississippi’s Medicaid program are using opioids at the same time as certain mental health medications, such as antidepressants, benzodiazepines, antipsychotics, and sleeping pills. These medications are sometimes used together to help with both pain and mental health problems. The research focused on people who filled at least one opioid prescription each year between 2016 and 2021. The goal was to understand how common this combined use is, how long people take both types of medicine together, and whether these patterns changed over time or differed by location.What were the results?The number of people filling opioid prescriptions went down over the six-year period. However, about one out of every three people who used opioids were also using a mental health medication in the same time period. The most common combination included antidepressants. While the overall number of people using both stayed about the same, the amount of time they were using both medicines together increased. Some counties in Mississippi had higher rates of combined use than others.What do the results of the study mean?Even though fewer people are getting opioids, those who do are more likely to take them alongside other medications for longer periods. This could raise health risks, especially when drugs are prescribed by different doctors without proper coordination. These findings show the importance of safer prescribing practices and better communication between doctors to help protect patients.
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