U.S. Opioid Prescriptions Aren't Falling, Says New Study

U.S. Opioid Prescriptions Aren't Falling, Says New Study

A new study from the Mayo Clinic says the number of opioid prescriptions across the U.S. have not declined, and in fact have remained relatively unchanged for many U.S. patients.

The study, published in the British Medical Journal (BMJ), shows that opioid prescription rates "have remained flat for commercially insured patients over the past decade. Rates for some Medicare patients are leveling but remain above where they were 10 years ago."

The news of this study comes just weeks after we reported how a different study found that opioid prescriptions were actually falling in certain states.

The reason for the differences is that the studies looked at two different situations.

In the earlier study we reported, researchers examined opioid prescribing patterns for Medicare and Medicaid patients in states where marijuana was legal.

The new Mayo Clinic study, however, examines opioid prescribing among patients with private commercial insurance and Advantage insurance plans. And it looked at the whole country.

In other words, the two studies are apples and oranges – completely different.

Results differ among groups

The new study was conducted by a cross-specialty team of physicians and researchers from Mayo Clinic, Yale University, The University of Alabama at Birmingham and Dartmouth College.

The team looked at insurance claims for prescription opioids from 2007 to 2016 among 48 million anonymous U.S. patients. They were commercially insured patients, 65-or-older Medicare Advantage patients, or Medicare Advantage beneficiaries younger than 65 who qualify for Medicare because of long-term disability.

Over one typical recent year, 14 percent of commercially insured patients, 26 percent of Medicare Advantage patients 65 and older and 52 percent of disabled Medicare Advantage patients received an opioid prescription.

Over the 10-year study period:

  • Disabled Medicare Advantage recipients had the highest rates of use and proportion of long-term use, and the largest average daily dose. Quarterly opioid use was lowest in 2007 at 26 percent, peaked in 2013 at 41 percent, and was 39 percent in 2016. Average daily dose increased from the equivalent of seven 5-milligrams of oxycodone to a high of about nine pills in 2012. In 2016, it went back to roughly eight pills.
  • Among Medicare Advantage recipients 65 and older, quarterly opioid use was lowest in 2007 at 11 percent, increased to 15 percent in 2010, and decreased to 14 percent by 2016. Average daily dose was roughly three 5-milligram doses of oxycodone and remained relatively unchanged.
  • For commercial patients, quarterly opioid use remained relatively flat at 6 to 7 percent for the 10 years. Average daily dose remained level at two 5-milligram doses of oxycodone.

The problem hasn't been solved

Opioid prescriptions in the U.S. increased dramatically from 1999 to 2010, according to the CDC, but then decreased from 2011 to 2015. But the 2015 total was still three times higher than the 1999 total and four times higher than amount prescribed per capita in Europe, the CDC said.

The new research found that while prescriptions have been leveling off since then, they're not really decreasing among most patient groups.

"Our data suggest not much has changed in prescription opioid use since about five years ago," says Molly Jeffery, Ph.D., lead study author and scientific director of the Mayo Clinic Division of Emergency Medicine Research. "I think we need to look at it and say, 'This problem isn't solved yet.' If you're hearing the message that prescription opioid use is starting to decline, I think we need to counter that and say that in most populations, it really isn't."

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