Changing Trends in Opioid Overdose Deaths and Prescription Opioid Receipt Among Veterans
Abstract
Introduction To inform overdose prevention, this study assessed both recent trends in opioid overdose mortality across opioid categories and receipt of prescription opioid analgesics among Veterans who died from overdose in the Veterans Health Administration.Methods Using Veterans Health Administration records linked to National Death Index data, annual cohorts (2010-2016) of Veterans who received Veterans Health Administration care were obtained and were examined by opioid overdose categories (natural/semisynthetic opioids, heroin, methadone, and other synthetic opioids) on (1) overdose rates and changes in rates adjusted for age, sex, and race/ethnicity; and (2) Veterans Health Administration prescription opioid receipt. Analyses were conducted in 2018.Results The overall rate of opioid overdose among Veterans increased from 14.47 per 100,000 person-years in 2010 to 21.08 per 100,000 person-years in 2016 (adjusted rate ratio=1.65, 95% CI=1.51, 1.81). There was a decline in methadone overdose (adjusted rate ratio=0.66, 95% CI=0.51, 0.84) and no significant change in natural/semisynthetic opioid overdose (adjusted rate ratio=1.08, 95% CI=0.94, 1.24). However, the synthetic opioid overdose rate (adjusted rate ratio=5.46, 95% CI=4.41, 6.75) and heroin overdose rate (adjusted rate ratio=4.91, 95% CI=3.92, 6.15) increased substantially. Among all opioid overdose decedents, prescription opioid receipt within 3 months before death declined from 54% in 2010 to 26% in 2016.Conclusions Opioid overdose rates among Veterans Health Administration Veterans increased because of increases in heroin and synthetic opioid overdose rates. Prescriptions of opioids declined among patients who died from all categories of opioid overdose; by 2016, only a minority received an opioid analgesic from Veterans Health Administration within 3 months of overdose. Future prevention efforts should extend beyond patients actively receiving opioid prescriptions.
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Over reliance on prescription opioids as a frontline treatment for chronic pain contributed to a national epidemic including increased rates of opioid addiction, accidental overdose, and mortality.
“Over reliance on the use of prescription opioids as a frontline treatment for chronic pain contributed to a national epidemic including increased rates of opioid addiction, accidental overdose, and even mortality [16–20].”
From Benchmark findings from a veteran electronic patient-reported outcomes evaluation from a chronic pain management telehealth program (2024) · cites this paper as [17]
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References 21 · Cited by 90
- Authors
- Lin, L. (., Peltzman, T., McCarthy, J. F., Oliva, E. M., Trafton, J. A., & Bohnert, A. S. B.
- Affiliations
- University of Michigan (US)
- VA Ann Arbor Healthcare System (US)
- United States Department of Veterans Affairs (US)
- Corresponding author
- Lin, Lewei (Allison)
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 57
- Issue
- 1
- Pages
- 106-110
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2945063720
- Cited by
- 90
- References
- 21
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 14 · 2023: 12 · 2022: 17 · 2021: 22 · 2020: 12 · 2019: 3
- FWCI
- 12.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- University of Michigan
- 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 › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid overdose deaths, veterans, prescription opioids, heroin overdose, methadone poisoning, opioid overdose prevention, Veterans Health Administration
- MeSH terms
- Adult, Analgesics, Opioid, Heroin, Female, Humans, Male, Methadone, Middle Aged, Opioid-Related Disorders, United States, United States Department of Veterans Affairs, Veterans, Drug Overdose, Prescription Drug Misuse
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