High prevalence of opioid use by social security disability recipients

Proportion of the disabled Medicare beneficiaries under the age of 65 filling 6 or more opioid prescriptions by Hospital Referral Region. There are large regional variations. Credit: Image courtesy of Wolters Kluwer Health: Lippincott Williams and Wilkins

Proportion of the disabled Medicare beneficiaries under the age of 65 filling 6 or more opioid prescriptions by Hospital Referral Region. There are large regional variations.
Credit: Image courtesy of Wolters Kluwer Health: Lippincott Williams and Wilkins

A recent study finds that 43.7% of disability recipients are taking prescription opioids. Many are on very high doses.

The researchers analyzed trends in use of prescription opioids (morphine-related drugs) among disabled Medicare beneficiaries under age 65 between 2007 and 2011. Nearly all under-65 Medicare beneficiaries are SSDI recipients; patients who go on SSDI are eligible for Medicare after two years.

Consistent with reports of an “opioid epidemic” in the United States, the results showed high and rising prevalence of opioid use by SSDI recipients. The percentage of beneficiaries taking opioids increased from 2007 through 2010. In 2011, the most recent year with available data, prevalence dipped slightly to 43.7 percent.

The percentage of these beneficiaries with chronic opioid use rose steadily, from 21.4 percent in 2007 to 23.1 percent in 2011. Chronic opioid users received numerous opioid prescriptions — at least six and generally 13 per year — typically prescribed by multiple doctors. Women were at greater risk of becoming chronic opioid users than men.

Among chronic opioid users, the average “morphine equivalent dose” (MED) also dipped in 2011. Still, nearly 20 percent of chronic users were taking a dose of at least 100 milligrams MED, while ten percent were taking 200 milligrams. “Opioid use of this intensity has been associated with risk of overdose death in the general US population and more specifically in disabled workers,” Dr Morden and colleagues write.

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