Table 1:
Characteristics of Medicare beneficiaries with new episodes of chronic low back pain, overall and by OUD status
| Overall | OUD Diagnosis | No OUD Diagnosis | |
|---|---|---|---|
| Age ≥65 years, % | 444,620 (73.2) | 19,310 (37.4) | 425,310 (76.5) |
| Mean age (SD), years | 68.2 (12.2) | 59.3 (12.6) | 69.1 (11.8) |
| Female sex, % | 389,707 (64.1) | 30,979 (60.0) | 358,728 (64.5) |
| Race, % | |||
| Non-Hispanic White | 487,717 (80.3) | 39,754 (76.9) | 447,963 (80.6) |
| Black or African-American | 56,016 (9.2) | 7,331 (14.2) | 48,685 (8.8) |
| Asian or Pacific Islander | 14,457 (2.4) | 310 (0.6) | 14,147 (2.5) |
| Hispanic (any race) | 34,296 (5.6) | 3,061 (5.9) | 31,235 (5.6) |
| American Indian or Alaska Native | 3,737 (0.6) | 577 (1.1) | 3,160 (0.6) |
| Other | 3,776 (0.6) | 250 (0.5) | 3,526 (0.6) |
| Unknown | 7,730 (1.27) | 360 (0.7) | 7,370 (1.3) |
| Had low-income subsidy, % | 222,678 (36.6) | 34,038 (65.9) | 188,640 (33.9) |
| Reason for current Medicare entitlement, % | |||
| Old age and survivors Insurance | 444,624 (73.2) | 19,314 (37.4) | 425,310 (76.5) |
| Disability insurance benefits | 161,585 (26.6) | 32,040 (62.1) | 129,545 (23.3) |
| End-stage renal disease | 868 (0.14) | 169 (0.3) | 699 (0.1) |
| Had dual enrollment, % | 203,060 (33.4) | 31,145 (60.3) | 171,915 (30.9) |
| U.S. Region, % | |||
| Midwest | 151,770 (24.9) | 9,303 (18.0) | 142,467 (25.6) |
| Northeast | 105,693 (17.4) | 8,042 (15.6) | 97,651 (17.6) |
| South | 239,249 (39.4) | 25,434 (49.3) | 213,815 (38.5) |
| West | 110,331 (18.2) | 8,853 (17.1) | 101,478 (18.3) |
| Other | 686 (0.11) | 11 (0.02) | 675 (0.1) |
| Metropolitan status, % | |||
| Metropolitan | 457,906 (75.4) | 38,753 (75.1) | 419,263 (75.4) |
| Rural | 48,075 (7.9) | 4,209 (8.2) | 43,974 (7.9) |
| Urban | 101,433 (16.7) | 8,681 (16.8) | 928,49 (16.7) |
| Medical conditions diagnosed | |||
| Non-back musculoskeletal pain | 330,196 (54.33) | 32,758 (63.4) | 297,438 (53.5) |
| Falls | 35,057 (5.8) | 4,178 (8.1) | 30,879 (5.6) |
| Fractures | 27,848 (4.6) | 3,332 (6.5) | 24,516 (4.4) |
| Surgeries | 25,718 (4.2) | 2,664 (5.2) | 23,054 (4.2) |
| Tobacco use disorder | 49,137 (8.1) | 11,526 (22.3) | 37,611 (6.8) |
| Alcohol use disorder | 8,669 (1.4) | 2,394 (4.6) | 6,275 (1.1) |
| Non-opioid drug use disorder | 14,362 (2.36) | 6,071 (11.8) | 8,291 (1.5) |
| Mental health disorder | 190,454 (31.34) | 28,289 (54.8) | 162,165 (29.2) |
| Diabetes (type 1 or 2) | 170,265 (28) | 15,021 (29.1) | 155,244 (27.9) |
| Cardiovascular disease | 127,458 (20.97) | 10,981 (21.3) | 116,477 (20.9) |
| Chronic obstructive pulmonary disease | 94,494 (15.5) | 12,879 (24.9) | 81,615 (14.7) |
| Asthma | 53,276 (8.8) | 6,103 (11.8) | 47,173 (8.5) |
| Hypertension | 387,044 (63.7) | 32,106 (62.2) | 354,943 (63.8) |
| Chronic kidney disease | 66,987 (11.1) | 5,734 (11.1) | 61,253 (11.1) |
| Drug overdose | 4,031 (0.6) | 1,758 (3.4) | 2,323 (0.4) |
| Dementia | 15,235 (2.51) | 1,121 (2.2) | 14,114 (2.5) |
| Gagne comorbidity score | |||
| <0 or 0 | 299,233 (49.24) | 18,676 (36.2) | 280,557 (50.5) |
| 1 | 124,663 (20.51) | 11,759 (22.8) | 112,904 (20.3) |
| 2 to 3 | 116,920 (19.24) | 12,362 (23.9) | 104,558 (18.8) |
| 4 or more | 66,913 (11.0) | 8,846 (17.1) | 58,067 (10.4) |
| Died during follow-up | 12,762 (2.1) | 1,859 (3.6) | 10,566 (1.9) |
| Physical therapy use | |||
| Baseline | 83,248 (13.7) | 4,687 (9.1) | 78,561 (14.1) |
| Follow-up | 149,831 (24.7) | 7,541 (14.6) | 142,290 (25.6) |
| Chiropractic care use | |||
| Baseline | 106,473 (17.5) | 2,330 (4.5) | 104,143 (18.7) |
| Follow-up | 164,370 (27.0) | 3,509 (6.8) | 160,861 (28.9) |
NOTE: OUD = opioid use disorder, SD = standard deviation
Non-back musculoskeletal pain includes neck pain, fibromyalgia, and osteoarthritis; Non-opioid drug use disorder includes cannabis, sedative, cocaine and other use disorders; Mental health disorder includes schizophrenia, bipolar disorder, mood disorder, major depressive disorder, anxiety disorder, and psychotic disorder; Cardiovascular disease includes ischemic heart disease and heart failure
All comparisons of groups with OUD versus without OUD had P-value <0.0001 with the exception of metropolitan status (P=0.046), cardiovascular disease (P=0.0901), and chronic kidney disease (P=0.5407)