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Outpatient, combined use of opioid and benzodiazepine medications in the United States, 1993–2014
- Source :
- Preventive Medicine Reports, Preventive Medicine Reports, Vol 9, Iss, Pp 49-54 (2018)
- Publication Year :
- 2017
- Publisher :
- Elsevier, 2017.
-
Abstract
- The combined use of opioid and benzodiazepine medications increases the risk of hazardous effects, such as respiratory depression. Although recent increases in outpatient use of opioid prescriptions have been documented, there are limited data regarding rates and correlates of combined opioid and benzodiazepines among adults in outpatient settings. Our objective was to examine annual trends in outpatient visits including opioids, benzodiazepines, and their combination among adults as well as clinical and demographic correlates. We used data from the 1993–2014 National Ambulatory Medical Care Survey (NAMCS) among non-elderly (i.e., ages 18–64 years) adults to examine the probability of a visit including an opioid, benzodiazepine, or their combination, in addition to clinical and demographic correlates. From 1993 to 2014, benzodiazepines-with-opioids visits increased from 9.8 to 62.5 (OR = 9.23, 95% CI = 5.45–15.65) per 10,000 visits. Highest-represented groups among benzodiazepines-with-opioids visits were older (50–64 years) (49.1%), white (88.8%), commercially insured (58.0%) patients during their first visit (87.6%) to a primary-care physician (41.9%). We identified a significant increase in the outpatient co-prescription of opioids and benzodiazepines, notably among adults aged 50–64 years during primary-care visits. Educational and policy changes to provide alternatives to benzodiazepine-with-opioid co-prescription and limiting opioid prescription to pain specialists may reduce rates of this potentially hazardous combination.<br />Highlights • Current guidelines for prescribing opioids recommend against co-administration with benzodiazepines • Concurrent use of opioids and benzodiazepines increases the risk of overdose, respiratory depression, and death. • We examined 22 years of outpatient prescribing patterns of opioids and benzodiazepines using a survey of US physicians. • Over this period, visits with both opioids and benzodiazepines increased from roughly 9.8 to 62.5 per 10,000 visits. • These visits were more likely among older (50–64 years), white, privately insured patients with a low-back pain diagnosis.
- Subjects :
- Aging
National Center for Health Statistics
lcsh:Medicine
ICD-9-CM
Medical care
Ninth Revision
Substance Misuse
0302 clinical medicine
odds ratio
Medicine
NAMCS
Prescription Drug Abuse
030212 general & internal medicine
RFV, reason-for-visit
RFV
Depression (differential diagnoses)
CDC, Centers for Disease Control and Prevention
NAMCS, National Ambulatory Medical Care Survey
Benzodiazepine
Pain Research
OR
Regular Article
CI
Health Services
National Ambulatory Medical Care Survey
3. Good health
NCHS, National Center for Health Statistics
Prescriptions
Prescription opioid
6.1 Pharmaceuticals
Ambulatory
Public Health and Health Services
Chronic Pain
medicine.drug
medicine.medical_specialty
medicine.drug_class
Combined use
Pain
Health Informatics
Opioid
Clinical Modification
Medication safety
03 medical and health sciences
ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification
International Classification of Diseases
Clinical Research
Centers for Disease Control and Prevention
reason-for-visit
Medical prescription
business.industry
lcsh:R
Public Health, Environmental and Occupational Health
Evaluation of treatments and therapeutic interventions
CI, confidence interval
OR, odds ratio
Good Health and Well Being
confidence interval
Emergency medicine
Generic health relevance
business
CDC
030217 neurology & neurosurgery
NCHS
Subjects
Details
- Language :
- English
- ISSN :
- 22113355
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Preventive Medicine Reports
- Accession number :
- edsair.doi.dedup.....ea7ba88148ccd886d0eb58bf776bf97b