Burden of Chronic and Heavy Opioid Use Among Elderly Community Dwellers in the U.S.
Morgan I. Bromley, Easter Protiva Gain, Mark’Quest J. Ajoku, Meredith Ray, Fawaz Mzayek, Satish Kedia, Xinhua Yu
Abstract
IntroductionOpioid over-prescribing may fuel the opioid epidemic and increase the risk of complications of opioid misuse. This study examined trends and determinants of chronic and heavy opioid use among elderly community dwellers in US.MethodsMedicare Current Beneficiary Surveys (MCBS) data from 2006 to 2019 were used. Common opioid medications were identified in the prescription medication files (n=47,264). Chronic users were defined as patients receiving six or more opioid prescriptions within a year or on medication for three or more months, and heavy users were those having average daily dose of 90 or more morphine milligram equivalents (MME) or 3780 MME or more per continuous treatment episode.ResultsOne-in-six elderly community dwellers ever-used opioids during the study period. Chronic users were more likely to be women than men (68.9% vs. 31.1%, P<0.001). Of all survey participants, 4.3% were chronic users and 2.8% were heavy users. Among ever-users 27.7% were chronic users, and 18.1% were heavy users. The rate of opioid use rose from 12.1% in 2006, peaked at 22.8% in 2013, and decreased to 11.7% in 2019. Chronic use was 5.1%, 10.7%, and 7.6%, respectively. Heavy use was 5.5%, 10.7%, and 7.6%, respectively. However, for chronic and heavy users, there was no significant difference in the median opioid dosage and opioid duration between males and females.ConclusionsAmong elderly Medicare beneficiaries, opioid prescriptions have been decreasing since 2013. However, a substantial number of elderly people were chronic and heavy users, calling for better opioid management among them.