Released on Wednesday, the Mayo Clinic study shows that the rate of opioid use has remained steady for most groups despite increased attention to opioid abuse.
“Our research of patient-level data doesn’t show the decline that was found in most previous research,” Molly Jeffery, the scientific director of the Mayo Clinic Division of Emergency Medicine Research and the lead author of the study, told Mayo Clinic News Network.
The research, published in the BMJ on August 1, 2018, showed that for commercially-insured patients, opioid prescriptions have remained flat over the past 10 years, with annual opioid usage remaining at 14 percent. The quarterly prescription rate also remained relatively steady for aged Medicare beneficiaries, increasing from 11 percent to 14 percent over the decade.
However, disabled Medicare recipients, who had the highest level of opioid use among the 48 million unidentified cases studied, saw a sharper increase, from 26 percent quarterly opioid use in 2007 to 39 percent in 2016. The average daily dose also increased.
“Based on these historical trends, there remains an unmet patient need to better target the use of prescription opioids,” says W. Michael Hooten, M.D., co-author, who is a Mayo Clinic anesthesiologist and pain specialist.
Different results from previous studies
Jeffrey explained that the study’s focus on individual patient data was what led the researchers to different conclusions from other recent studies. The researchers had different questions. “Did fewer people have opioid prescriptions? Did people taking opioids take less over time? When we looked at it that way, we found a different picture.”
As the study reports: “Studies reporting on population-level opioid use have had some key limitations. Sales and supply data track nearly all legally distributed opioids, but these data do not link to patient demographics. The National Survey on Drug Use and Health includes patient information, but is limited to patient self-reports of opioid use and excludes children under age 12 years.”
Medicare fee-for-service data—provides excellent patient-level data, but is limited to Medicare beneficiaries. So one can see the limitations if only one source is used. Jeffrey said their study “wanted to know how the declines were experienced by individual people” rather than the patterns “in the total amount of opioids prescribed across the whole market,” according to Science Daily.
The study did not include people with Medicaid insurance, those covered by the Department of Veterans Affairs or Tricare (military insurance), or the uninsured.
Opioid crisis the in U.S. getting worse
The United States has the highest rate of opioid use in the world, consuming 88 percent more prescription opioids per capita than second-ranked Germany and seven times more than the United Kingdom.
Overdoses rose 30 percent in all parts of the US from July 2016 through September 2017, according to the CDC, that also reports that 63,632 Americans died from drug overdoses in 2016, with two-thirds of those deaths being attributed to opioids.
The study, “Trends in opioid use in commercially insured and Medicare Advantage populations in 2007-16: retrospective cohort study,” was a collaborative effort by a cross-specialty team of physicians and researchers from Mayo Clinic, Yale University, The University of Alabama at Birmingham and Dartmouth College.
