Research snapshot: Opioid prescriptions common among Medicare beneficiaries

The often devastating misuse of prescription opioids has slowly caught the media and public’s attention in recent years. It is estimated that opioid addiction affected nearly 2.5 million adults in the U.S. in 2014. Some estimates suggest more than 44,000 drug overdose-related deaths occurred in 2013 and nearly one-third of those deaths were attributed to prescription opioids. Furthermore, prescription opioid abuse can often lead to heroin use (and eventual addiction) when addicts can no longer get prescription medication and/or they move on to cheaper, easily accessible and stronger heroin.

Tragically, an estimated 40 people die every day from opioid drug overdoses.

The University of Minnesota is doing its part to take on this public health crisis and recently hosted Pain. Pill. Problem., an all-day conference that examined the many facets of Minnesota’s issues with opiate abuse.

Now, new research recently published in JAMA Internal Medicine found prescribing opioids was common following hospital discharges among Medicare beneficiaries who previously had no opioid use prior to hospitalization.

“We know that even short-term opioid prescriptions can lead to long term use,” said Pinar Karaca-Mandic, Ph.D., senior author and associate professor of health policy and management in the University of Minnesota’s School of Public Health. “We must try to understand why hospitals vary in their post-discharge opioid prescriptions. It’s concerning that large variations in post-discharge prescribing remain, especially with abuse so prevalent today.”

The study also found:

  • 15 percent of beneficiaries filled a new prescription within seven days of their discharge
  • Likelihood of post-discharge opioid prescribing varied substantially across hospitals even after accounting for patient characteristics, severity and diagnoses
  • There appears to be a modest link between patient pain management scores and post-discharge opioid prescribing.

“One of the more glaring and possibly problematic findings was nearly 40 percent of patients with a new opioid prescription filled the prescription 90 days after their discharge, suggesting long term use,” said Karaca-Mandic.

Karaca-Mandic adds that in order to reduce large variations in post-discharge opioid prescribing across hospitals, current hospital incentives to promote adequate pain control could be coupled with other measures that aim to target and promote appropriate opioid use. Currently there is a system that offers incentives better pain management, but measures on appropriateness of the opioid prescribing are missing.

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