Opioid Prescriptions for US Patients With Cancer, Non-Cancer Pain Falls, Study Results Show

The number of individuals in the United States who are privately insured and are prescribed opioid medication for cancer pain and non-cancer-related chronic pain declined between 2012 and 2019, according to the results of a study conducted by Sachini Bandara and Emma McGinty of Johns Hopkins Bloomberg School of Public Health and Mark Bicket of the University of Michigan and published in PLOS ONE.¹

Previous study results have shown that overall US opioid prescribing rates decreased between 2010 and 2020, but the recommendations on opioid usage specifically exempt individuals in active care treatment form the limits.¹

“We find that from 2012 [to] 2019, there were declines in opioid prescribing for individuals with chronic non-cancer pain and individuals with cancer without corresponding increases in receipt of non-opioid therapies. These findings highlight the need to better understand how declines in prescribing are influencing the management of pain among these patient populations, particularly as the CDC is currently updating opioid prescribing guidelines for chronic pain,” study investigators said in a statement.¹

In this study, investigators used the IBM MarketScan Research Databases from 2012 to 2019, which include health insurance claims for approximately 26.¹ million to 53.1 million individuals who are covered by about 100 private insurance companies in the United States.¹

The investigators identified individuals with a cancer diagnosis or a non-cancer-related chronic pain diagnosis, including arthritis, headaches, lower back pain, and neuropathic pain, for each calendar year.¹

Over the time period studied, the proportion of individuals who received opioid prescriptions dropped to 30.5% from 49.7% for individuals with non-cancer-related chronic pain and to 78.7% from 86% for those with cancer.¹

Additionally, rates of non-opioid pain medication remained consistent for those with non-cancer-related chronic pain at 66.4% and 66.7% and increased for individuals with cancer to 78.8% from 74.4%.¹

Investigators also found that the most commonly prescribed non-opioid pain medications among those with non-cancer related chronic pain were anticonvulsants, antidepressants, and non-steroidal anti-inflammatory medications.²

For those with cancer pain, the most commonly prescribed non-opioid pain medications were anticonvulsants, antidepressants, and steroids.²

Among those with an opioid prescription, the number of prescriptions per individuals ranged from 5.2 to 3.9 in the non-cancer related chronic pain arm and 4 to 2.7 for those with cancer pain, investigators reported.²

Opioid prescribing has declined for both groups, without the corresponding substitution for non-opioid related therapies to manage pain, investigators concluded.

Future work is needed to examine how the changed could influence the management of pain in both of these groups, they said.¹

Study findings align with other research suggesting that the prescription of opioids has decreased in the general population following CDC guidelines that were released in 2016, investigators said.²

Investigators noted that their study was limited by data of administrative claims, therefore a variety of factors about the individuals could not be determined.²

References

1. Declines in opioid prescriptions for U.S. patients with cancer and non-cancer pain, study shows. News release. EurekAlert. August 10, 2022. Accessed August 11, 2022. https://www.eurekalert.org/news-releases/960699

2. Bandara S, Bicket MC, McGinty EE. Trends in opioid and non-opioid treatment for chronic non-cancer pain and cancer pain among privately insured adults in the United States, 2012-2019. PLoS One. 2022;17(8):e0272142. doi:10.1371/journal.pone.0272142