Among Social Security Disability Insurance recipients, more than 40% take opioid pain relievers and the prevalence of chronic opioid use is more than 20% and increasing, according to recently published data.
Researchers identified fee-for-service beneficiaries less than 65 years old from a 40% random-sample Medicare denominator and created annual enrollment cohorts from 2007 to 2011. Adjusted, annual opioid use measures were obtained, including any use, chronic use, intensity of use and opioid prescribers per user. Researchers also studied geographic variation across Hospital Referral Regions.
Study results showed a peak in most measures in 2010, with adjusted proportions of any opioid use at 43.9% in 2007, 44.7% in 2010 and 43.7% in 2011. Researchers found an increase in the proportion of chronic use from 21.4% in 2007 to 23.1% in 2011. According to study results, mean morphine equivalent dose (MED) peaked at 81.3 mg in 2010 among chronic users, but then declined in 2011 to 77.4 mg. In 2011, 19.8% of chronic users received 100 or more mg MED, while 10.4% received 200 or more mg. Study results showed a variation in hospital referral region-level measures in 2011 with any use ranging from 33% to 58.6%; chronic use ranging from 13.9% to 36.6%; a mean MED of 45 mg to 125 mg among chronic users; and a mean annual opioid prescribers of 2.4 to 3.7.
“Our findings call attention to the complex and potentially unique health care needs of disabled workers under the age of 65 years. They suffer a high burden of illness and injury, low incomes, and now, a high burden of opioid use,” the researchers wrote. “Medicare administrators and clinicians must respond to the importance of high quality pain management in this population.”
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Disclosure: The researchers received support from the National Institutes of Health and the National Institutes on Aging. Morden, Colla and Munson received support from SYNERGY at Dartmouth and Dartmouth Hitchcock Medical Center. Morden received support from the Robert Wood Johnson Foundation Dartmouth Atlas project.