title: Trends in long-term opioid therapy for noncancer pain among persons with a history of depression.
abstract: OBJECTIVE
  We report trends in long-term opioid use among patients with a history of depression from two large health plans.
  
  
  METHODS
  Using claims data, age- and gender-adjusted rates for long-term (>90 days) opioid use episodes were calculated for 1997-2005, comparing those with and without a depression diagnosis in the prior 2 years. Opioid use characteristics were calculated for those with a long-term episode in 2005.
  
  
  RESULTS
  Incident and prevalent long-term opioid use rates were three times higher in those with a history of depression. Prevalent long-term use per 1000 in patients with a history of depression increased from 69.8 to 125.9 at Group Health and from 84.3 to 117.5 at Kaiser Permanente of Northern California between 1997 and 2005. Those with a history of depression were more likely to receive a higher average daily dose, greater days supply, and Schedule II opioids than nondepressed persons.
  
  
  CONCLUSIONS
  Persons with a history of depression are more likely to receive long-term opioid therapy for noncancer pain than those without a history of depression. Results suggest that long-term opioid therapy for noncancer pain is being prescribed to a different population in clinical practice than the clinical trial populations where opioid efficacy has been established.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Box 356560, University of Washington, Seattle, WA 98195-6560, USA. jkbrenn@u.washington.edu
authors.forename: Jennifer Brennan
authors.initials: JB
authors.lastname: Braden
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Ray
authors.forename: Kathleen
authors.initials: K
authors.lastname: Saunders
authors.forename: Joseph
authors.initials: J
authors.lastname: Merrill
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Rutter
authors.forename: Constance
authors.initials: C
authors.lastname: Weisner
authors.forename: Caleb
authors.initials: C
authors.lastname: Banta-Green
authors.forename: Cynthia
authors.initials: C
authors.lastname: Campbell
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002140:California; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000639:trends; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D012189:Retrospective Studies; D014861:Washington; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine