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Trends in opioid prescribing and co-prescribing of sedative hypnotics for acute and chronic musculoskeletal pain: 2001-2010: Trends in Opioid and Sedative Prescribing
Abstract
PURPOSE: Characterize trends in opioid prescribing and co-prescribing of sedative hypnotics at acute and chronic musculoskeletal pain visits from 2001 to 2010. METHODS: We conducted a repeated cross-sectional analysis of 15 344 visits for acute pain and 19 958 visits for chronic pain in the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey from 2001 to 2010. The primary outcome was receipt of an opioid, and secondary outcomes were co-prescribing of a benzodiazepine or sedative hypnotic (benzodiazepine, muscle relaxant, or insomnia medications). We used multivariable logistic regression to assess temporal trends. RESULTS: Between 2001 and 2010, opioid prescribing at acute and chronic musculoskeletal pain visits increased by 50% (10.4% [95%CI 7.9-12.9%] to 15.6% [95%CI 12.5-18.6%]) and 79% (12.9% [95%CI 9.7-16.0%] to 23.1% [95%CI 18.3-27.9%]), respectively. For chronic pain visits, opioid prescribing plateaued between 2006 and 2010, and spline analysis detected a possible 2007 peak at 28.2% (95%CI 21.4-34.9%) of visits. Benzodiazepines were co-prescribed with opioids at 8.1% (95%CI 6.0-10.1%) of acute pain visits and 15.5% (95%CI 12.8-18.2%) of chronic pain visits. Sedative hypnotics were co-prescribed at 32.7% (95%CI 28.9-36.5%) of acute pain visits and 36.1% (95%CI 32.5-39.8%) of chronic pain visits. We found no evidence for decreased co-prescribing of opioids and sedative hypnotics by any of our measures. CONCLUSIONS: Opioid prescribing for acute and chronic musculoskeletal pain increased from 2001 to 2010, plateauing from 2006 to 2010 for chronic pain visits. Co-prescribing of opioids and sedative hypnotics is common and may represent a target for interventions to improve the safety of opioid prescribing.
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Previous studies found that coprescribing opioids with benzodiazepines is common.
“Previous studies found that coprescribing with opioids is common.13,35,36,37”
From Patterns in Outpatient Benzodiazepine Prescribing in the United States (2019) · cites this paper as [37]
Previous studies did not examine coprescribing with other sedating medications and focused on overlapping prescription periods.
“Those studies, however, did not examine coprescribing with other sedating medications and focused on overlapping prescriptions periods, which could be the result of prescriptions given to a patient at different times or by different prescribers.”
From Patterns in Outpatient Benzodiazepine Prescribing in the United States (2019) · cites this paper as [37]
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Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013
Bachhuber, M. A., Hennessy, S., Cunningham, C. O., & Starrels, J. L. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303061 · Cited by 531
Patterns in Outpatient Benzodiazepine Prescribing in the United States
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Metadata
- Authors
- Larochelle, M. R., Zhang, F., Ross-Degnan, D., & Wharam, J. F.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
- Corresponding author
- Larochelle, Marc R.
- Venue
- Pharmacoepidemiology and Drug Safety
- Publisher
- Wiley
- Published
- 2015-04-22
- Volume
- 24
- Issue
- 8
- Pages
- 885-892
- ISSN
- 1053-8569 (ISSN-L)
- OpenAlex
- W1928905073
- Cited by
- 114
- References
- 1
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 12 · 2023: 6 · 2022: 8 · 2021: 13 · 2020: 15 · 2019: 21 · 2018: 8 · 2017: 12 · 2016: 9 · 2015: 2
- FWCI
- 11.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Pharmacoepidemiology and Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- HRSA (T32 HP10251, T32 HP12706)
- Ryoichi Sasakawa, Fellowship Fund
- Harvard Pilgrim Health Care Institute
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- opioid prescribing, sedative-hypnotic drugs, benzodiazepines, co-prescribing, musculoskeletal pain, acute pain, chronic pain, temporal trends, outpatient visits, muscle relaxants, insomnia medication, prescription drug use, pain management strategies, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, opioid epidemic
- MeSH terms
- Adolescent, Adult, Aged, Analgesics, Opioid, Cross-Sectional Studies, Drug Therapy, Combination, Female, Humans, Hypnotics and Sedatives, Male, Middle Aged, Practice Patterns, Physicians', Drug Prescriptions, Risk Factors, Time Factors, United States, Multivariate Analysis, Logistic Models, Databases, Factual, Drug Utilization Review, Pharmacoepidemiology, Young Adult, Chronic Pain, Musculoskeletal Pain, Acute Pain
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