title: Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2012.
abstract: BACKGROUND
  There is growing concern about potential overuse of, and toxicity from, opioid analgesics. No nationally representative study has examined inter-state variations in opioid use and impact of policy on opioid use among older adults.
  
  
  METHODS
  We used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. We excluded those with a cancer diagnosis. Multilevel, multivariable regression analyses evaluated rates of prolonged prescriptions for schedule II, schedule III, and combination II/III opioid for each state, adjusting for patient characteristics.
  
  
  RESULTS
  The percent of Part D recipients receiving prescriptions for combined schedule II/III opioid more than 90 days in a year increased from 4.62% in 2007 to 7.35% in 2012. Large variations existed among states in rates of opioid prescriptions: from 2.84% in New York to 10.93% in Utah, in 2012 data. The state variation was larger for schedule III than schedule II. Individual characteristics independently associated with prolonged use included older age, female gender, white race, low income, living in a lower-education area, and comorbidity of drug abuse, rheumatoid arthritis, and depression. Only state law regulating pain clinic was associated with reduction of schedule II opioid prescriptions. Prolonged opioid prescription use increased the odds of opioid overdose-related emergency room visits or hospitalization by 60%.
  
  
  CONCLUSIONS
  Analyses of Medicare Part D data demonstrated a substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.
authors.affiliation: Department of Internal Medicine, The University of Texas Medical Branch, Galveston; Sealy Center on Aging, The University of Texas Medical Branch, Galveston; Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston; Institute for Translational Science, The University of Texas Medical Branch, Galveston. Electronic address: yokuo@utmb.edu.
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine, The University of Texas Medical Branch, Galveston; Sealy Center on Aging, The University of Texas Medical Branch, Galveston.
authors.forename: Mukaila A
authors.initials: MA
authors.lastname: Raji
authors.affiliation: Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston.
authors.forename: Nai-Wei
authors.initials: NW
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, The University of Texas Medical Branch, Galveston.
authors.forename: Hunaid
authors.initials: H
authors.lastname: Hasan
authors.affiliation: Department of Internal Medicine, The University of Texas Medical Branch, Galveston; Sealy Center on Aging, The University of Texas Medical Branch, Galveston; Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston; Institute for Translational Science, The University of Texas Medical Branch, Galveston.
authors.forename: James S
authors.initials: JS
authors.lastname: Goodwin
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy; D062787:Drug Overdose / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D054524:Medicare Part D; D059408:Pain Management / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid
keywords: Medicare; Opioid; Overdose; Regulations