Effect of age on opioid prescribing, overdose, and mortality in Massachusetts, 2011 to 2015
Journal of the American Geriatrics Society, 2019•Wiley Online Library
Objectives To examine the effect of age on the likelihood of PIP of opioids and the effect of
PIP on adverse outcomes. Design Retrospective cohort study. Setting Data from multiple
state agencies in Massachusetts from 2011 to 2015. Participants Adult Massachusetts
residents (N= 3,078,163) who received at least one prescription opioid during the study
period; approximately half (1,589,365) aged 50 and older. Measurements We measured
exposure to 5 types of PIP: high‐dose opioids, coprescription with benzodiazepines …
PIP on adverse outcomes. Design Retrospective cohort study. Setting Data from multiple
state agencies in Massachusetts from 2011 to 2015. Participants Adult Massachusetts
residents (N= 3,078,163) who received at least one prescription opioid during the study
period; approximately half (1,589,365) aged 50 and older. Measurements We measured
exposure to 5 types of PIP: high‐dose opioids, coprescription with benzodiazepines …
Objectives
To examine the effect of age on the likelihood of PIP of opioids and the effect of PIP on adverse outcomes.
Design
Retrospective cohort study.
Setting
Data from multiple state agencies in Massachusetts from 2011 to 2015.
Participants
Adult Massachusetts residents (N=3,078,163) who received at least one prescription opioid during the study period; approximately half (1,589,365) aged 50 and older.
Measurements
We measured exposure to 5 types of PIP: high‐dose opioids, coprescription with benzodiazepines, multiple opioid prescribers, multiple opioid pharmacies, and continuous opioid therapy without a pain diagnosis. We examined 3 adverse outcomes: nonfatal opioid overdose, fatal opioid overdose, and all‐cause mortality.
Results
The rate of any PIP increased with age, from 2% of individuals age 18 to 29 to 14% of those aged 50 and older. Older adults also had higher rates of exposure to 2 or more different types of PIP (40–49, 2.5%; 50–69, 5%; ≥70, 4%). Of covariates assessed, older age was the greatest predictor of PIP. In analyses stratified according to age, any PIP and specific types of PIP were associated with nonfatal overdose, fatal overdose, and all‐cause mortality in younger and older adults.
Conclusion
Older adults are more likely to be exposed to PIP, which increases their risk of adverse events. Strategies to reduce exposure to PIP and to improve outcomes in those already exposed will be instrumental to addressing the opioid crisis in older adults. J Am Geriatr Soc 67:128–132, 2019.
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