title: Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV.
abstract: Harms of opioid analgesics, especially high-dose therapy among individuals with comorbidities and older age, are increasingly recognized. However, trends in opioid receipt among HIV-infected patients are not well characterized. We examined trends, from 1999 to 2010, in any and high-dose (≥120 mg/day) opioid receipt among patients with and without HIV, by age strata, controlling for demographic and clinical correlates. Of 127,216 patients, 64 % received at least one opioid prescription. Opioid receipt increased substantially among HIV-infected and uninfected patients over the study; high-dose therapy was more prevalent among HIV-infected patients. Trends in high-dose receipt stratified by three age groups revealed an increasing trend in each age strata, higher among HIV-infected patients. Correlates of any opioid receipt included HIV, PTSD and major depression. Correlates of high-dose receipt included HIV, PTSD, major depression and drug use disorders. These findings suggest a need for appropriate balance of risks and benefits, especially as these populations age.
authors.affiliation: Internal Medicine, West Haven VA Medical Center, VA Connecticut Healthcare System, Mail Stop 151B, 950 Campbell Avenue, West Haven, CT, 06516, USA. william.becker@yale.edu.|Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. william.becker@yale.edu.
authors.forename: William C
authors.initials: WC
authors.lastname: Becker
authors.affiliation: Internal Medicine, West Haven VA Medical Center, VA Connecticut Healthcare System, Mail Stop 151B, 950 Campbell Avenue, West Haven, CT, 06516, USA.
authors.forename: Kirsha
authors.initials: K
authors.lastname: Gordon
authors.affiliation: Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Edelman
authors.affiliation: Psychology, VA Connecticut Healthcare System, West Haven, CT, USA.|Psychology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Kerns
authors.affiliation: Center for Health Services Research, Rutgers University, New Brunswick, NJ, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
authors.affiliation: Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Dziura
authors.affiliation: Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Fiellin
authors.affiliation: University of Pittsburgh and Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
authors.affiliation: Psychology, VA Connecticut Healthcare System, West Haven, CT, USA.|Psychology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Goulet
authors.affiliation: Internal Medicine, West Haven VA Medical Center, VA Connecticut Healthcare System, Mail Stop 151B, 950 Campbell Avenue, West Haven, CT, 06516, USA.|Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.affiliation: Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
mesh_terms: D059787:Acute Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D015995:Prevalence; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D000701:Analgesics, Opioid
keywords: Aging; Analgesics; Chronic; Human immunodeficiency virus; Opioids; Pain