Trends in long-term opioid therapy for noncancer pain among persons with a history of depression

Gen Hosp Psychiatry. Nov-Dec 2009;31(6):564-70. doi: 10.1016/j.genhosppsych.2009.07.003. Epub 2009 Aug 27.

Abstract

Objective: We report trends in long-term opioid use among patients with a history of depression from two large health plans.

Methods: Using claims data, age- and gender-adjusted rates for long-term (>90 days) opioid use episodes were calculated for 1997-2005, comparing those with and without a depression diagnosis in the prior 2 years. Opioid use characteristics were calculated for those with a long-term episode in 2005.

Results: Incident and prevalent long-term opioid use rates were three times higher in those with a history of depression. Prevalent long-term use per 1000 in patients with a history of depression increased from 69.8 to 125.9 at Group Health and from 84.3 to 117.5 at Kaiser Permanente of Northern California between 1997 and 2005. Those with a history of depression were more likely to receive a higher average daily dose, greater days supply, and Schedule II opioids than nondepressed persons.

Conclusion: Persons with a history of depression are more likely to receive long-term opioid therapy for noncancer pain than those without a history of depression. Results suggest that long-term opioid therapy for noncancer pain is being prescribed to a different population in clinical practice than the clinical trial populations where opioid efficacy has been established.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesics, Opioid / therapeutic use*
  • California
  • Comorbidity
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Dose-Response Relationship, Drug
  • Drug Utilization / trends
  • Female
  • Humans
  • Long-Term Care / trends
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain / drug therapy*
  • Pain / epidemiology*
  • Pain / psychology
  • Retrospective Studies
  • Washington
  • Young Adult

Substances

  • Analgesics, Opioid
  • Morphine