title: Use of opioids and other analgesics by older adults in the United States, 1999-2010.
abstract: OBJECTIVE
  There has been concern over rising use of prescription opioids in young and middle-aged adults. Much less is known about opioid prescribing in older adults, for whom clinical recommendations and the balance of risks and benefits differ from younger adults. We evaluated changes in use of opioids and other analgesics in a national sample of clinic visits made by older adults between 1999 and 2010.
  
  
  METHODS
  Observational study of adults aged 65 and older from the 1999-2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, serial cross-sectional surveys of outpatient visits in the United States.
  
  
  METHODS
  Medication use was assessed at each study visit and included medications in use prior to the visit and medications newly prescribed at the visit. Results were adjusted for survey weights and design factors to provide nationally representative estimates.
  
  
  RESULTS
  Mean age was 75 ± 7 years, and 45% of visits occurred in primary care settings. Between 1999-2000 and 2009-2010, the percent of clinic visits at which an opioid was used rose from 4.1% to 9.0% (P < 0.001). Although use of all major opioid classes increased, the largest contributor to increased use was hydrocodone-containing combination opioids, which rose from 1.1% to 3.5% of visits over the study period (P < 0.001). Growth in opioid use was observed across a wide range of patient and clinic characteristics, including in visits for musculoskeletal problems (10.7% of visits in 1999-2000 to 17.0% in 2009-2010, P < 0.001) and in visits for other reasons (2.8% to 7.3%, P < 0.001).
  
  
  CONCLUSIONS
  Opioid use by older adults visiting clinics more than doubled between 1999 and 2010, and occurred across a wide range of patient characteristics and clinic settings.
authors.affiliation: Division of Geriatrics, San Francisco VA Medical Center, University of California, San Francisco, California, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Steinman
authors.forename: Kiya D R
authors.initials: KD
authors.lastname: Komaiko
authors.forename: Kathy Z
authors.initials: KZ
authors.lastname: Fung
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: Aged; Analgesics; Opioid Analgesics; Pharmacoepidemiology; Physician's Practice Patterns; United States