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. 2013 Sep;74(9):932-9.
doi: 10.4088/JCP.13m08349.

National trends in the office-based prescription of schedule II opioids

Mark Olfson  1 , Shuai Wang, Miren Iza, Stephen Crystal, Carlos Blanco
Affiliations

National trends in the office-based prescription of schedule II opioids

Mark Olfson et al. J Clin Psychiatry. 2013 Sep.

Abstract

Objective: To investigate national trends and patterns in opioid prescription within office-based medical practice.

Method: An analysis is presented of 1995-2010 data from the National Ambulatory Medical Care Survey, focusing on overall and stratified trends in the percentage of medical visits involving prescriptions for Schedule II opioids. Among visits with opioid prescriptions in 2003-2010, first-time visits were also compared to return visits, and visits in which pain was the primary complaint were compared to visits with other primary complaints.

Results: Among all office visits, the percentage with an opioid prescription increased from 0.65% in 1995-1998 to 2.63% in 2007-2010 (odds ratio [OR] = 8.01; 95% CI, 4.96-12.94). During the study period (1995-2010), opioid prescriptions significantly increased in visits by male patients (OR = 6.54; 95% CI, 3.21-13.31); female patients (OR = 9.38; 95% CI, 6.70-13.14); and patients aged 18-35 years (OR = 5.82; 95% CI, 2.59-13.10), 36-64 years (OR = 8.30; 95% CI, 4.63-14.86), and ≥ 65 years (OR = 8.85; 95% CI, 6.13-12.77), but not ≤ 17 years (OR = 1.52; 95% CI, 0.50-4.63). Prescriptions for opioids also significantly increased in visits by patients with clinical depression (OR = 9.96; 95% CI, 5.45-18.21) or anxiety (OR = 10.99; 95% CI, 5.02-24.06) diagnoses. However, a significant decline occurred in opioid prescriptions in visits among patients with substance use diagnoses (OR = 0.10; 95% CI, 0.00-3.30). The number of opioid prescriptions rose faster among patients making a first visit (OR = 23.36; 95% CI, 11.82-46.17) versus a return visit (OR = 7.26; 95% CI, 4.38-12.03).

Conclusions: A substantial increase occurred between 1995 and 2010 in opioid prescriptions in office-based medical visits, especially in visits by middle-aged and older adults and by patients making their first visit to the treating physician. These trends suggest that physicians have pursued greater pain control despite potential risks of nonmedical use of prescription opioids.

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Conflict of interest statement

Potential conflicts of interest: None reported.

Figures

Figure 1.
Figure 1.
National Estimates of Annual Number of Visits With Opioid Prescriptions in Office-Based Medical Care in 1995–2010 in the United States
See this image and copyright information in PMC

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