Dangerous Drug Combos Common Among Opioid Tx Patients

Almost 60% of patients on opioid pain treatments for long-term conditions were prescribed potentially dangerous medication mixtures during the same time period, with women accounting for nearly two-thirds of these patients, according to a new report from Express Scripts.

The report, A Nation in Pain, outlines the use of prescription opioid medications in the United States from 2009–2013 by 36 million de-identified pharmacy claims of 6.8 million commercially insured Americans of all ages. While the number of patients taking prescription opioids on a long-term basis remained fairly constant during the study period, the number of opioid prescriptions filled and the number of days of medicine per prescription rose by over 8% over the past five years. Prevalence rates did differ significantly based on location, with approximately 4% of Americans in the study were using prescription opioids on a long-term basis in 2013 compared to 5.1% of those in small cities. Among small cities with less than 28,000 residents, the top five had 12.3–18% of their population using prescription opioids; these cities were predominately located in Alabama, Arkansas, Georgia, and Kentucky.

Among the nearly 60% of patients taking potentially dangerous medication mixtures, close to one in three patients were on both an opiate and a benzodiazepine (the most common cause of multiple drug overdose deaths) and about 28% were taking a muscle relaxant. Eight percent reported combining an opioid, muscle relaxant, and a benzodiazepine and 27% were taking multiple opioid pain treatments simultaneously. Two-thirds of the patients were prescribed the medications by two or more physicians, and nearly 40% filled their prescriptions at more than one pharmacy.

Almost half of patients who taking opioids for more than 30 days in the first year continued to use them for three years or longer and nearly half took only short-acting medications. Women were 30% more likely than men to use an opioid pain medication, while men filled more frequent and potent opioid prescriptions. The elderly had the highest prevalence rate of opioid use; younger adults filled more frequent opioid prescriptions.

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