title: Use of opioid analgesics in skin disorders: Results from a nationally representative US sample.
abstract: BACKGROUND
  Increasing and inappropriate use of opioid analgesics (OA) have been declared a public health concern in the United States. There are no epidemiologic studies of OA use in skin disorders. We examined OA use in a nationally representative sample of US patient visits with only physician-diagnosed skin disorders.
  
  
  METHODS
  Retrospective cross-sectional study of 56 751 patient visits from 1995 to 2010 (International Classification of Diseases, 9th Revision, Clinical Modification codes 680-709 denoting "Diseases of the Skin and Subcutaneous Tissue"; 172, 173, 216 and 232 denoting malignant and benign skin neoplasms).
  
  
  RESULTS
  An estimated 3.1% ± 0.2% of skin disorders visits were associated with OA use; 52.7% ± 5.4% were Schedule III opioids; 11.4% ± 1.4% of OA visits involved skin neoplasms and 45.4% ± 2.3% cellulitis and abscess. OA use increased from 1995 to 2010 (adjusted OR = 1.82, 95% CI: 1.49-2.22), even after controlling for increase in the frequency of skin infections from 1995 to 2010.
  
  
  CONCLUSIONS
  The most frequent use OA for cellulitis and abscess is entirely consistent with their Food and Drug Administration (FDA)-approved indications for pain management. The almost two-fold increase in OA use in skin disorders from 1995 to 2010 may suggest that OA are being considered for pain management earlier in therapy.
  
  
  CONCLUSIONS
  Only a minority of patient visits with OA had primary dermatologic disease. OA are being used in dermatology primarily for FDA-approved indications.
authors.affiliation: Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario , London, Ontario , Canada .
authors.forename: Madhulika A
authors.initials: MA
authors.lastname: Gupta
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Branka
authors.initials: B
authors.lastname: Vujcic
authors.forename: Meghan
authors.initials: M
authors.lastname: Piccinin
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003880:Dermatology / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012871:Skin Diseases / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy*; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: Dermatology; epidemiology; narcotics; opioid analgesics; pain; skin cancer; skin disease