Opioid prescription rates in lower back pain patients on the decline

  • Azad TD & al.
  • J Gen Intern Med
  • 12.11.2019

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Although rates of opioid prescription in opioid-naive patients with lower back pain (LBP) or lower extremity pain (LEP) decreased nearly 8% between 2008 and 2015, prescribing rates of benzodiazepines decreased by just >1% during the same period.
  • Nearly 20% of patients received prescriptions for both opioids and benzodiazepines.

Why this matters

  • Patients who were coprescribed both drugs received significantly higher doses of opioids and had a greater risk for long-term opioid use.

Study design

  • 2,497,653 opioid-naive patients with newly diagnosed LBP or LEP were assessed.
  • Funding: None disclosed.

Key results

  • 31.9% and 11.5% of patients received opioid or benzodiazepine prescriptions, respectively.
  • From 2008 to 2015, there was a decrease in the rates of opioid prescribing from 34.8% to 27.0% (P<.001>
  • No significant change in the rates of benzodiazepine prescribing was noted (11.6% to 10.7%; P=.031).
  • Greater opioid consumption was noted among patients who had received benzodiazepine (1-way analysis of variance; P<.001 style="list-style-type:circle;">
  • 6 months before and 12 months after the diagnosis (continued use),
  • only 12 months after the diagnosis (new use), and
  • only 6 months before the diagnosis.
  • Higher risks for long-term opioid use was noted in patients with continued (OR, 2.99) and new (OR, 2.69; both P<.001 benzodiazepine use.>

    Limitations

    • Retrospective study.

    Coauthored with Chitra Ravi, MPharm