Prescription Opioid Use among Adults with Mental Health Disorders in the United States

Davis, Matthew; Lin, Lewei Allison; Liu, Haiyin; Sites, Brian D.

doi:10.3122/jabfm.2017.04.170112

Cited by 210 publications

(161 citation statements)

References 26 publications

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“…Among Medicare enrollees aged 65 and older, the 10% who have disability as an original entitlement comprised 25% of prolonged opioid users and 40% of high‐dose users in 2015. One explanation for the high rate of risky opioid use among disability‐entitled enrollees is the clustering of known risk factors—mood disorders, cognitive disability, and back pain‐related disorders—associated with opioid misuse …”

Section: Discussionmentioning

confidence: 99%

Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products

Kuo

Raji

Liaw

et al. 2018

J American Geriatrics Society

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OBJECTIVES To examine how an October 2014 Drug Enforcement Administration policy reclassified hydrocodone product from schedule III to II has affected older adults, who are among the largest consumers of prescription opioids in the United States. DESIGN Retrospective cohort study. SETTING United States. PARTICIPANTS A 20% sample of Medicare Part D beneficiaries aged 65 and older from 2013 through 2015 (> 2,500,000 beneficiaries each year) MEASUREMENTS From January 2013 to December 2015, we calculated the monthly prevalence of opioid prescriptions and the prevalence of individuals who received prescriptions for a 90-day supply or longer (prolonged), as well as hospitalizations related to opioid toxicity in 2013 and 2015. RESULTS From 2013 to 2015, the proportion of Medicare Part D enrollees who received a hydrocodone prescription in a year decreased from 21.9% to 18.3%. Monthly rates for hydrocodone prescriptions declined significantly in 2014. The risk of receiving prolonged opioid prescriptions decreased by approximately 7% in the multivariable analyses comparing 2015 to 2013 (prevalence ratio=0.93, 95% confidence interval (CI)=0.93–0.94). Medicare enrollees with an original entitlement because of disability or with Medicaid eligibility had smaller decreases in prolonged prescriptions and, unexpectedly, small increases in high-dose prescriptions. Opioid-related hospitalizations did not change significantly, but opioid-related hospitalizations without a documented opioid prescription increased (odds ratio=1.24, 95% CI=1.03–1.50). CONCLUSION The 2014 change in hydrocodone from schedule III to schedule II was associated with modest decreases in rates of opioid use in the elderly. The unexpected increase in opioid-related hospitalizations without documented opioid prescriptions may represent an increase in illegal use.

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Section: Discussionmentioning

confidence: 99%

Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products

Kuo

Raji

Liaw

et al. 2018

J American Geriatrics Society

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“…The psychosocial context in which substance use exists has been linked to mental illness among criminal justice-involved African Americans (Calcaterra et al, 2014; Western et al, 2015). More specific to NMOU, cross-sectional studies (Davis et al, 2017), meta-analyses (Fischer et al, 2012), secondary analyses of population-based surveys (Ashrafioun et al, 2017), and longitudinal analysis (Martins et al, 2012) have revealed individuals who engage in NMOU are significantly more likely to have mental health problems. Others have posited NMOU is motivated by the desire to attenuate psychological distress (Martins et al, 2009; Martins et al, 2012).…”

Section: 0 Introductionmentioning

confidence: 99%

Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Knighton

Stevens‐Watkins

Staton

et al. 2018

Addictive Behaviors

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Background The Centers for Disease Control and Prevention has deemed nonmedical opioid use (NMOU) an epidemic. Population-based survey data indicate high rates of NMOU among Caucasians, however, these estimates exclude incarcerated samples and may underestimate use among criminal justice-involved African Americans. Despite opioid-associated risks of co-occurring mental illness and mortality, to our knowledge, this is the first study to examine NMOU and mental health among a sample of African American men receiving corrections-based substance use disorder (SUD) treatment in jail, prison, or the community. Method We conducted a cross-sectional study examining trends and mental health correlates of NMOU during the year prior to each participant’s incarceration, across five cohorts of African American men (N = 4,021) enrolled in corrections-based SUD treatment between the years, 2010 and 2014. A series of chi-square, ANOVAs, correlations, and logistic regression models were conducted. Results Over 20% of our sample reported NMOU during the year prior to incarceration. On average, participants were 36-years-old, earned 13 years of education, and were generally unemployed, prior to incarceration. We found a statistically significant positive linear trend between NMOU prior to incarceration and cohort year. The final stepwise multivariate regression model was significant and revealed, older age was associated with lower odds of NMOU. More years of education and frequent mental health symptoms were associated with significantly increased odds of NMOU. Discussion Our findings are unique in that extant literature has primarily described NMOU as a ‘White suburban’ problem. Culturally-adapted behavioral interventions and medication assisted therapies are discussed.

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“…To examine whether there were differences in the depression and high-potency opioid use association as a function of arthritis diagnosis, we constructed additional multivariable logistic regression models controlling for gender, age, race/ethnicity, education, marital status, smoking status, BMI, diabetes, arthritis, hypertension, and cancer ( [12][13][14] This emerging body of literature should be of concern to professionals in geriatric psychiatry, gerontology, and other agingrelated disciplines, because it suggests that high-potency opioid medication is potentially interfering with safer, more appropriate mental health and medical treatment among high-risk older adults with severe depressive symptoms. 16 We deliberately examined whether there were differences in degree of association between high-potency opioid medication use and depression category as a function of arthritis diagnosis.…”

Section: Post Hoc Testsmentioning

confidence: 99%

Likelihood of depressive symptoms in US older adults by prescribed opioid potency: National Health and Nutrition Examination Survey 2005‐2013

Brooks

Petersen

Kelly

et al. 2019

Int J Geriat Psychiatry

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Objectives To investigate the relationships between depressive symptoms and opioid potency among adults aged 50 years and older reporting use of one or more prescription opioids in the past 30 days. Materials/Design Adjusted multiple linear regression models were conducted with 2005‐2013 files from a secondary cross‐sectional dataset, the National Health and Nutrition Examination Survey (NHANES). Respondents were community‐dwelling, noninstitutionalized adults 50 years or older (n = 1036). Predictor variables included a positive screen for minor depression symptoms (Patient Health Questionnaire [PHQ‐9] score greater than or equal to 5 and less than or equal to 9), moderate depression symptoms (PHQ‐9 greater than or equal to 10 and less than or equal to 14), and severe depression symptoms (PHQ‐9 greater than or equal to 15). Criterion variables included weaker‐than‐morphine analgesics (eg, codeine and tramadol) and morphine‐equivalent opioids (eg, morphine and hydrocodone), which served as the reference category, as well as stronger‐than‐morphine opioid analgesics (eg, fentanyl and oxycodone). Results Prevalence rates for symptoms of minor depression, moderate depression, and severe depression were n = 236 (22.8%), n = 135 (13.0%), and n = 122 (11.8%), respectively. Severe depression was significantly associated with high‐potency opioid use (odds ratio [OR]: 2.27; confidence interval [CI], 1.16‐4.46). In post hoc tests, severe depression remained significantly associated with high‐potency opioid use only among respondents without arthritis (OR: 5.80; CI, 1.59‐21.13). Conclusions Compared with older adults without depressive symptoms, older adults with severe depressive symptoms are more likely to be taking high‐potency opioid medications. Future prescription opioid medication research should prioritize investigations among older adults with pain‐related diagnoses, other than arthritis, reporting preexisting or new symptoms of severe depression.

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Prescription Opioid Use among Adults with Mental Health Disorders in the United States

Cited by 210 publications

References 26 publications

Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products

Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products

Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Likelihood of depressive symptoms in US older adults by prescribed opioid potency: National Health and Nutrition Examination Survey 2005‐2013

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