Opioid Use in Disabled Medicare Patients Common
(HealthDay News) — Opioid use is common among disabled Medicare beneficiaries <65 years of age, according to research published in the September issue of Medical Care.
Nancy E. Morden, MD, MPH, from the Dartmouth Hitchcock Medical Center in Lebanon, NH, and colleagues analyzed data from a 40% random-sample Medicare denominator to identify disabled, fee-for-service beneficiaries <65 years of age (2007–2011). Annual opioid use was characterized by the following: any use, chronic use (at least six prescriptions), intensity of use (daily morphine equivalent dose [MED]), and opioid prescribers per user. Variation was studied geographically across Hospital Referral Regions.
The researchers found that most measures peaked in 2010. Over the study period, the adjusted proportion with any opioid use was 43.9% in 2007, 44.7% in 2010, and 43.7% in 2011. Chronic use rose from 21.4% in 2007 to 23.1% in 2011. Mean MED among chronic users peaked at 81.3mg in 2010 and declined to 77.4mg in 2011, with 19.8% receiving ≥100mg MED and 10.4% receiving ≥200mg in 2011. Hospital Referral Region-level measures varied broadly in 2011 (fifth to 95th percentile), with any use ranging from 33.0–58.6%; chronic use from 13.9 to 36.6%; mean MED among chronic users from 45–125mg; and mean annual opioid prescribers from 2.4–3.7.
"Variation shows a lack of a standardized approach and reveals regions with mean MED at levels associated with overdose risk," the authors write.