The incidence of opioid use disorder among people with acute and chronic pain managed with prescription opioids in the United States: economic and societal burden

AIMS: This retrospective, longitudinal, observational study evaluated the incidence of opioid use disorder (OUD) among patients newly initiating opioids to manage acute and chronic pain in the United States. Additionally, healthcare resource utilization (HCRU) and associated costs were analyzed. MATERIALS AND METHODS: Adult patients newly treated with prescription opioids were identified within the MarketScan administrative claims databases (2016-2018). Patients were classified as experiencing acute or chronic pain based on total prescription pain medication use within one year of the initial opioid prescription. Subgroups of patients with or without OUD were identified using diagnosis codes. RESULTS: The 1-, 2-, and 3-year incidence rates of OUD were 0. 21%, 0. 32%, and 0. 43%, respectively, among acute pain patients and 1. 11%, 1. 52%, and 1. 92% among chronic pain patients. Unadjusted all-cause HCRU were substantially higher among patients with OUD compared to those without OUD over the 12-month period following OUD diagnosis. The associated unadjusted total all-cause healthcare costs were 3. 1-times and 2. 0-times higher for those with OUD compared to those without OUD in the acute and chronic pain cohorts, respectively. The total all-cause healthcare costs for patients with OUD remained significantly higher, even after adjusting for baseline characteristics. When extrapolated nationally, estimated costs for patients managing acute or chronic pain and newly diagnosed with OUD were 3. 3 billion (B) and 5. 9B, respectively, totaling 9. 2B. LIMITATIONS: Pain medication use was identified using claims for filled prescriptions; patients' actual medication usage and use of over-the-counter medications cannot be ascertained. OUD diagnosis was based on specific ICD-10-CM diagnosis codes, potentially underestimating the true incidence and economic impact. CONCLUSIONS: Newly diagnosed OUD following prescription opioid use for managing acute and chronic pain imposes a substantial economic burden within the first year following OUD diagnosis. Increased use of effective non-opioid analgesics may help reduce the incidence and economic burden of OUD.