Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV

AIDS Behav. 2016 Mar;20(3):679-86. doi: 10.1007/s10461-015-1197-5.

Abstract

Harms of opioid analgesics, especially high-dose therapy among individuals with comorbidities and older age, are increasingly recognized. However, trends in opioid receipt among HIV-infected patients are not well characterized. We examined trends, from 1999 to 2010, in any and high-dose (≥120 mg/day) opioid receipt among patients with and without HIV, by age strata, controlling for demographic and clinical correlates. Of 127,216 patients, 64 % received at least one opioid prescription. Opioid receipt increased substantially among HIV-infected and uninfected patients over the study; high-dose therapy was more prevalent among HIV-infected patients. Trends in high-dose receipt stratified by three age groups revealed an increasing trend in each age strata, higher among HIV-infected patients. Correlates of any opioid receipt included HIV, PTSD and major depression. Correlates of high-dose receipt included HIV, PTSD, major depression and drug use disorders. These findings suggest a need for appropriate balance of risks and benefits, especially as these populations age.

Keywords: Aging; Analgesics; Chronic; Human immunodeficiency virus; Opioids; Pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Pain / drug therapy
  • Acute Pain / epidemiology
  • Acute Pain / etiology
  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / therapeutic use
  • Chronic Pain / drug therapy*
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Drug Administration Schedule
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Pain / epidemiology
  • Pain / etiology
  • Pain Management / methods
  • Pain Management / statistics & numerical data
  • Pain Management / trends*
  • Prevalence
  • Sex Factors
  • United States / epidemiology
  • Veterans / statistics & numerical data*

Substances

  • Analgesics, Opioid