Opioid pain treatment declines in the U.S., but largest proportion is seniors: Study

Researchers have found that from 2015 to 2023, the number of patients prescribed long‐term opioid therapy for pain declined. They said this could have been due to “national opioid stewardship efforts and growing awareness of the risks.” Still, about 4 to 5 million patients did receive these prescriptions in 2023, the researchers wrote, adding that the patients tended to be older, and that the largest proportion now had their treatment covered by Medicare. This is of concern because older adults are at higher risk of adverse effects of polypharmacy, the researchers wrote, citing in particular the combination of gabapentin and opioids. Long‐term opioid therapy was defined as 90 days or longer, and is typically prescribed for patients with chronic pain. The researchers examined the IQVIA Longitudinal Prescription Database to identify opioid prescriptions dispensed from April 2012 to December 2023. They calculated the annual number of patients with long‐term opioid therapy episodes, and assessed changes between 2015 and 2023 in payer type and therapy characteristics, including mean daily oral morphine milligram equivalents and coprescribing. In 2023, patients with long‐term opioid therapy episodes accounted for 11.5% of all patients with any opioid episodes. The highest share (40.9%) of long‐term opioid therapy episodes in 2015 was covered by commercial insurance, and the highest share (48.7%) in 2023 was covered by Medicare. Study limitations included lack of information on prescribing indications (reasons for the prescription), patient comorbidities, and prescriber characteristics. The study was published online April 8 in the Journal of the American Medical Association, and the corresponding author was Thuy D. Nguyen, Ph.D., of the University of Michigan School of Public Health.