OBJECTIVE: To assess changes in utilization of prescription opioids among adults by various medical conditions over a period of 10 years in the United States using a nationally representative database.
METHODS: A trend analysis was conducted using the Medical Expenditure Panel Survey data from 2007 to 2016. National estimates were obtained by conducting weighted analyses. Prescription opioid utilization and the number of opioid prescriptions per 100 persons were calculated among adults (18 years and older) by year and medical condition requiring an opioid prescription. Medical conditions were grouped into the following categories: cardiorespiratory, dental, ear-nose-throat, gastrointestinal, hematologic/oncologic, infection, neurologic and migraine, nontraumatic orthopedic, skin/dermatological, urogenital, and trauma. An interrupted time series analysis was conducted to evaluate the statistical significance of the observed utilization trend.
RESULTS: Opioid utilization increased from 2007 to a peak in prevalence in 2014 (16.1%), then decreased to 13.3% in 2016. Similarly, 64 opioid prescriptions per 100 persons were observed in 2014, which decreased to 48 prescriptions per 100 persons in 2016. Common medical conditions associated with opioid prescriptions were nontraumatic orthopedic (32.6%), trauma (16.9%), dental (7.2%), urogenital (6.4%), and neurologic and migraine (5.4%). A decline in opioid prescriptions was observed from 2014 to 2016 across the common conditions, except dental, where a marginal increase was observed from 2014 (12.1%) to 2016 (13.3%). The interrupted time series analysis showed a statistically significant decreasing trend after 2014 (P = 0.0228).
CONCLUSIONS: Findings from this study and other national reports suggest that the increased awareness of the opioid crisis in the United States may have influenced the declining trend of opioid use before the declaration of a public health emergency in 2017.
