More than half of all opioids prescribed in the United States are for patients who have a mental health disorder, according to a study published in the Journal of the American Board of Family Medicine.
Matthew A. Davis, MPH, PhD, from the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, and colleagues conducted a cross-sectional study of noninstitutionalized adults using data from the Medical Expenditure Panel Survey (MEPS). They sought to examine the relationship between mental health disorders, such as mood and anxiety disorders, and prescription opioid use, which was defined as receiving at least 2 prescriptions within a calendar year.
A total of 52,000 adults (aged 18 years and older) participated in the MEPS in 2011 and 2013 (25,465 in 2011 and 26,535 in 2013). Data from 2012 were excluded because of duplication of participants from the overlapping panel design.
The investigators estimated that 38.6 million patients have a mental health disorder in the US; among this group, 7.2 million (18.7%) use prescription opioids. Adults with a mental health disorder receive 51.4% (60 million of 115 million prescriptions) of the total opioid prescriptions distributed annually in the US.
In addition, adults with a mental health disorder are significantly more likely to use opioids compared with adults who do not have a mental health disorder (18.7% vs 5.0%, respectively). In adjusted analyses, the researchers found that having a mental health disorder was associated with prescription opioid use overall (odds ratio, 2.08).
“Our findings that patients with mental illness are more likely to receive opioid prescriptions across all different levels of pain suggests that there may be additional patient- and provider-related factors specific to those with mental illness that increase the likelihood of receiving prescription opioids,” stated Dr Davis’s group. “Such a relationship is particularly concerning because mental illness is also a prominent risk factor for overdose and other adverse opioid-related outcomes.
“Thus,” the study authors continued, “the expectation would be that physicians would be more conservative with their prescribing behaviors in the setting of mental illness and favor non-opioid alternatives. The ability to identify populations that may use prescription opioids independent of pain would be of strategic importance for mitigating potential risk at a population health level.”
- Davis MA, Lin LA, Liu H, Sites BD. Prescription opioid use among adults with mental health disorders in the United States. J Am Board Fam Med. 2017;30. doi:10.3122/jabfm.2017.04.170112