Factors Associated with Prescription of Opioids and Co-prescription of Sedating Medications in Individuals with HIV.
Opioids are often prescribed for chronic pain, and opioid risks such as overdose and death are heightened when opioids are co-prescribed with other sedating medications. We investigated factors associated with chronic opioid prescription, alone and in combination with benzodiazepines and muscle relaxants, in a clinical cohort of individuals with HIV. We used multivariable logistic regression models to determine participant clinical and demographic characteristics that are associated with chronic prescription of opioids or chronic co-prescription of opioids with sedating medications. Among 1474 participants, chronic prescription of opioids occurred in 253 individuals (17.2 %), and chronic co-prescription occurred in 90 individuals (6.1 %). Age >50, public insurance as compared to private insurance, and symptoms of depression and anxiety were significantly associated with chronic opioid prescription and chronic co-prescription. Our findings raise concern that opioid prescription and co-prescription of sedating medications occurs disproportionately in patients for whom use is riskier.
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, BBRB 222, 1530 3rd Ave S, Birmingham, AL, 35294-2170, USA. jmerlin@uab.edu.|Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA. jmerlin@uab.edu.
Jessica S
JS
Merlin
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, BBRB 222, 1530 3rd Ave S, Birmingham, AL, 35294-2170, USA.
Ashutosh
A
Tamhane
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Joanna L
JL
Starrels
Birmingham VA Medical Center, Birmingham, AL, USA.|Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Stefan
S
Kertesz
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, BBRB 222, 1530 3rd Ave S, Birmingham, AL, 35294-2170, USA.
Michael
M
Saag
Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA.
Karen
K
Cropsey
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001007:Anxiety; D001569:Benzodiazepines / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D017678:Sex Distribution; D014481:United States
D000701:Analgesics, Opioid; D009125:Muscle Relaxants, Central; D001569:Benzodiazepines
Benzodiazepine; Chronic pain; HIV; Muscle relaxant; Opioid