TY - JOUR
KW - benzodiazepine
KW - buprenorphine
KW - opioid analgesic
KW - Overdose
KW - pharmacoepidemiology
KW - Substance Abuse
AU - L. J. Paulozzi
AU - C. Zhou
AU - C. M. Jones
AU - L. Xu
AU - C. S. Florence
A1 - 
AB - PURPOSE: When providers recognize that patients are abusing prescription drugs, review of the drugs they are prescribed and attempts to treat the substance use disorder are warranted. However, little is known about whether prescribing patterns change following such a diagnosis. METHODS: We used national longitudinal health claims data from the Market Scan(R) commercial claims database for January 2010-June 2011. We used a cohort of 1.85 million adults 18-64 years old prescribed opioid analgesics but without abuse diagnoses during a 6-month "preabuse" period. We identified a subset of 9009 patients receiving diagnoses of abuse of non-illicit drugs (abuse group) during a 6-month "abuse" period and compared them with patients without such a diagnosis (nonabuse group) during both the abuse period and a subsequent 6-month "postabuse" period. RESULTS: During the abuse period 5.78% of the abuse group and 0.14% of the nonabuse group overdosed. Overdose rates declined to 2.12% in the abuse group in the postabuse period. Opioid prescribing rates declined 13.5%, and benzodiazepine rates declined 12.3% in the abuse group in the post-abuse period. Antidepressants and gabapentin were prescribed to roughly one half and one quarter of the abuse group, respectively, during all three periods. Daily opioid dosage did not decline in the abuse group following diagnosis. CONCLUSIONS: Prescribing to people who abuse drugs changes little after their abuse is documented. Actions such as tapering opioid and benzodiazepine prescriptions, maximizing alternative treatments for pain, and greater use of medication-assisted treatment such as buprenorphine could help reduce risk in this population. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
BT - Pharmacoepidemiology and drug safety
C5 - Opioids & Substance Use; Education & Workforce
CP - 5
CY - England
DO - 10.1002/pds.3980
IS - 5
JF - Pharmacoepidemiology and drug safety
N2 - PURPOSE: When providers recognize that patients are abusing prescription drugs, review of the drugs they are prescribed and attempts to treat the substance use disorder are warranted. However, little is known about whether prescribing patterns change following such a diagnosis. METHODS: We used national longitudinal health claims data from the Market Scan(R) commercial claims database for January 2010-June 2011. We used a cohort of 1.85 million adults 18-64 years old prescribed opioid analgesics but without abuse diagnoses during a 6-month "preabuse" period. We identified a subset of 9009 patients receiving diagnoses of abuse of non-illicit drugs (abuse group) during a 6-month "abuse" period and compared them with patients without such a diagnosis (nonabuse group) during both the abuse period and a subsequent 6-month "postabuse" period. RESULTS: During the abuse period 5.78% of the abuse group and 0.14% of the nonabuse group overdosed. Overdose rates declined to 2.12% in the abuse group in the postabuse period. Opioid prescribing rates declined 13.5%, and benzodiazepine rates declined 12.3% in the abuse group in the post-abuse period. Antidepressants and gabapentin were prescribed to roughly one half and one quarter of the abuse group, respectively, during all three periods. Daily opioid dosage did not decline in the abuse group following diagnosis. CONCLUSIONS: Prescribing to people who abuse drugs changes little after their abuse is documented. Actions such as tapering opioid and benzodiazepine prescriptions, maximizing alternative treatments for pain, and greater use of medication-assisted treatment such as buprenorphine could help reduce risk in this population. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
PB - . This article is a U.S. Government work and is in the public domain in the USA
PP - England
PY - 2016
SN - 1099-1557; 1053-8569
SP - 545
EP - 552
EP - 
T1 - Changes in the medical management of patients on opioid analgesics following a diagnosis of substance abuse
T2 - Pharmacoepidemiology and drug safety
TI - Changes in the medical management of patients on opioid analgesics following a diagnosis of substance abuse
U1 - Opioids & Substance Use; Education & Workforce
U2 - 26861165
U3 - 10.1002/pds.3980
VL - 25
VO - 1099-1557; 1053-8569
Y1 - 2016
ER -