Cirrhosis: opioid prescribing on the rise among veterans

  • Clin Gastroenterol Hepatol

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • 77% of veterans with cirrhosis received at least 1 opioid prescription in the past year, and 41% met the definition for chronic opioid use.
  • Opioid prescribing among veterans with cirrhosis increased from 36% in 2005 to 47% from 2011 to 2014.

Why this matters

  • Liver disease is a significant risk factor for opioid-related complications, including overdose.

Study design

  • Retrospective study evaluated 127,239 veterans with cirrhosis identified from national Veterans Health Administration data (2005-2014).
  • Funding: VA Center for Health Equity Research and Promotion.

Key results

  • 77% of veterans with cirrhosis were prescribed opioid medications at least once over a median follow-up period of 7 years.
  • 41% of veterans met the definition of long-term opioid use (≥90 calendar days) in at least 1 year.
  • Veterans with cirrhosis receiving opioid medications increased from 36% in 2005 to 47% in 2011-2014 (Ptrend<.001>
  • Proportion of veterans receiving long-term prescriptions increased from 47% in 2005 to 54% in 2014 (Ptrend<.001>
  • 19% of recipients were prescribed high-dose opioids (≥100 morphine milligram equivalents/day).

Limitations

  • Reliance on administrative data.
  • Indication for opioid use not identified.

Coauthored with Antara Ghosh, PhD

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