Bobbi Jo H Yarborough1, Scott P Stumbo1, Ashley Stoneburner1, Ning Smith1, Steven K Dobscha2,3, Richard A Deyo1,4, Benjamin J Morasco2,3. 1. Kaiser Permanente Northwest Center for Health Research, Portland, Oregon. 2. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon. 3. Department of Psychiatry, Oregon Health & Science University, Portland, Oregon. 4. Departments of Family Medicine, Internal Medicine, and the Oregon Institute for Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA.
Abstract
OBJECTIVE: To examine the correlates and odds of receiving overlapping benzodiazepine and opioid prescriptions and whether co-prescription was associated with greater odds of falling or visiting the emergency department. DESIGN: Cross-sectional study. SETTING: A large private integrated health system and a Veterans Health Administration integrated health system. SUBJECTS: Five hundred seventeen adults with musculoskeletal pain and current prescriptions for long-term opioid therapy. METHODS: A multivariate logistic regression model examined correlates of having overlapping benzodiazepine and opioid prescriptions in the year before enrollment in the cross-sectional study. Negative binomial models analyzed the number of falls in the past three months and past-year emergency department visits. In addition to propensity score adjustment, models controlled for demographic characteristics, psychiatric diagnoses, medications, overall comorbidity score, and opioid morphine equivalent dose. RESULTS: Twenty-five percent (N = 127) of participants had co-occurring benzodiazepine and opioid prescriptions in the prior year. Odds of receiving a benzodiazepine prescription were significantly higher among patients with the following psychiatric diagnoses: anxiety disorder (adjusted odds ratio [AOR] = 4.71, 95% confidence interval [CI] = 2.67-8.32, P < 0.001), post-traumatic stress disorder (AOR = 2.24, 95% CI = 1.14-4.38, P = 0.019), and bipolar disorder (AOR = 3.82, 95% CI = 1.49-9.81, P = 0.005). Past-year overlapping benzodiazepine and opioid prescriptions were associated with adverse outcomes, including a greater number of falls (risk ratio [RR] = 3.27, 95% CI = 1.77-6.02, P = 0.001) and emergency department visits (RR = 1.66, 95% CI = 1.08-2.53, P = 0.0194). CONCLUSIONS: Among patients with chronic pain prescribed long-term opioid therapy, one-quarter of patients had co-occurring prescriptions for benzodiazepines, and dual use was associated with increased odds of falls and emergency department visits.
OBJECTIVE: To examine the correlates and odds of receiving overlapping benzodiazepine and opioid prescriptions and whether co-prescription was associated with greater odds of falling or visiting the emergency department. DESIGN: Cross-sectional study. SETTING: A large private integrated health system and a Veterans Health Administration integrated health system. SUBJECTS: Five hundred seventeen adults with musculoskeletal pain and current prescriptions for long-term opioid therapy. METHODS: A multivariate logistic regression model examined correlates of having overlapping benzodiazepine and opioid prescriptions in the year before enrollment in the cross-sectional study. Negative binomial models analyzed the number of falls in the past three months and past-year emergency department visits. In addition to propensity score adjustment, models controlled for demographic characteristics, psychiatric diagnoses, medications, overall comorbidity score, and opioid morphine equivalent dose. RESULTS: Twenty-five percent (N = 127) of participants had co-occurring benzodiazepine and opioid prescriptions in the prior year. Odds of receiving a benzodiazepine prescription were significantly higher among patients with the following psychiatric diagnoses: anxiety disorder (adjusted odds ratio [AOR] = 4.71, 95% confidence interval [CI] = 2.67-8.32, P < 0.001), post-traumatic stress disorder (AOR = 2.24, 95% CI = 1.14-4.38, P = 0.019), and bipolar disorder (AOR = 3.82, 95% CI = 1.49-9.81, P = 0.005). Past-year overlapping benzodiazepine and opioid prescriptions were associated with adverse outcomes, including a greater number of falls (risk ratio [RR] = 3.27, 95% CI = 1.77-6.02, P = 0.001) and emergency department visits (RR = 1.66, 95% CI = 1.08-2.53, P = 0.0194). CONCLUSIONS: Among patients with chronic pain prescribed long-term opioid therapy, one-quarter of patients had co-occurring prescriptions for benzodiazepines, and dual use was associated with increased odds of falls and emergency department visits.
Authors: Eric J Hawkins; Carol A Malte; Joel Grossbard; Andrew J Saxon; Zac E Imel; Daniel R Kivlahan Journal: J Addict Med Date: 2013 Sep-Oct Impact factor: 3.702
Authors: Jessica S Merlin; Sarah R Young; Joanna L Starrels; Soraya Azari; E Jennifer Edelman; Jamie Pomeranz; Payel Roy; Shalini Saini; William C Becker; Jane M Liebschutz Journal: J Gen Intern Med Date: 2017-12-04 Impact factor: 5.128
Authors: Bradley D Stein; Joshua Mendelsohn; Adam J Gordon; Andrew W Dick; Rachel M Burns; Mark Sorbero; Regina A Shih; Rosalie Liccardo Pacula Journal: J Addict Dis Date: 2016-07-22
Authors: Joseph W Frank; Cari Levy; Daniel D Matlock; Susan L Calcaterra; Shane R Mueller; Stephen Koester; Ingrid A Binswanger Journal: Pain Med Date: 2016-05-20 Impact factor: 3.750
Authors: Alfredo J Selim; Graeme Fincke; Xinhua S Ren; Austin Lee; William H Rogers; Donald R Miller; Katherine M Skinner; Mark Linzer; Lewis E Kazis Journal: J Ambul Care Manage Date: 2004 Jul-Sep
Authors: Patrick D Quinn; Kwan Hur; Zheng Chang; Erin E Krebs; Matthew J Bair; Eric L Scott; Martin E Rickert; Robert D Gibbons; Kurt Kroenke; Brian M D'Onofrio Journal: Pain Date: 2017-01 Impact factor: 7.926
Authors: Benjamin J Morasco; Ning Smith; Steven K Dobscha; Richard A Deyo; Stephanie Hyde; Bobbi Jo Yarborough Journal: J Gen Intern Med Date: 2020-11-03 Impact factor: 5.128
Authors: Jennifer D Ellis; Jill A Rabinowitz; Jonathan Wells; Fangyu Liu; Patrick H Finan; Michael D Stein; Denis G Antoine Ii; Gregory J Hobelmann; Andrew S Huhn Journal: J Affect Disord Date: 2021-12-04 Impact factor: 4.839
Authors: Shirley Musich; Shaohung S Wang; Luke B Slindee; Joann Ruiz; Charlotte S Yeh Journal: Popul Health Manag Date: 2019-11-25 Impact factor: 2.459