Table 1.
Baseline descriptive characteristics of the study sample
| Characteristics | Cases (n = 817) | Controls (n = 8,170) | |
|---|---|---|---|
| n (%) | n (%) | P Value | |
| DEMOGRAPHICS | |||
| Age (years), median (IQR) | 62 (10) | 62 (16) | <0.001 |
| Age Group (years) | |||
| 18–34 | 27 (3.3) | 565 (6.9) | <0.001 |
| 35–44 | 31 (3.8) | 619 (7.6) | |
| 45–54 | 115 (14.2) | 1,240 (15.2) | |
| 55–64 | 377 (46.1) | 2,672 (32.7) | |
| 65+ | 267 (32.7) | 3,074 (37.6) | |
| Male | 753 (92.2) | 7,528 (92.1) | 0.98 |
| Race | |||
| Non‐hispanic White | 555 (67.9) | 4,546 (55.6) | <0.001 |
| Non‐hispanic Black | 8 (10.2) | 1,300 (15.9) | |
| Hispanic | 32 (3.9) | 431 (5.3) | |
| Other | 147 (18) | 1,893 (23.2) | |
| Marital Status | |||
| Never married | 102 (12.5) | 1,227 (15) | <0.001 |
| Married | 351 (43) | 4,246 (52) | |
| Separated | 20 (2.5) | 41 (0.5) | |
| Divorced | 285 (34.9) | 2,268 (27.8) | |
| Widowed | 59 (7.2) | 388 (4.8) | |
| Body Mass Index (BMI, kg/m2) | |||
| Underweight (<18.5) | 29 (3.6) | 72 (0.9) | <0.001 |
| Normal (18.5–24.9) | 193 (23.6) | 1,197 (14.7) | |
| Overweight (25.0–29.9) | 224 (27.4) | 2,070 (25.3) | |
| Obese (≥30.0) | 306 (37.5) | 2,667 (32.6) | |
| Missing | 65 (8) | 2,164 (26.5) | |
| U.S. Census Region | |||
| Northeast | 75 (9.2) | 824 (10.1) | <0.001 |
| North Central | 190 (23.3) | 1,745 (21.4) | |
| South | 270 (33.1) | 3,258 (39.9) | |
| West | 257 (31.5) | 1,842 (22.6) | |
| Other | 25 (3.1) | 501 (6.1) | |
| CLINICAL CHARACTERISTICS | |||
| CCI score, mean (SD) | 3.9 (3.3) | 1.7 (2) | <0.001 |
| Individual CCI Comorbidities | |||
| Myocardial infarction | 28 (3.4) | 105 (1.3) | <0.001 |
| Congestive heart failure | 93 (11.4) | 308 (3.8) | <0.001 |
| Peripheral vascular disease | 71 (8.7) | 353 (4.3) | <0.001 |
| Cerebrovascular disease | 57 (7) | 343 (4.2) | <0.001 |
| Dementia | 5 (0.6) | 32 (0.4) | 0.35 |
| Chronic pulmonary disease | 291 (35.6) | 1,047 (12.8) | <0.001 |
| Rheumatologic disease (serious autoimmune) | 6 (0.7) | 96 (1.2) | 0.26 |
| Peptic ulcer disease | 9 (1.1) | 63 (0.8) | 0.312 |
| Mild liver disease | 43 (5.3) | 64 (0.8) | <0.001 |
| Diabetes | 263 (32.2) | 1,850 (22.6) | <0.001 |
| Hypertension | 495 (60.6) | 3,670 (44.9) | <0.001 |
| Depression | 357 (43.7) | 1,562 (19.1) | <0.001 |
| Use of warfarin | 78 (9.6) | 387 (4.7) | <0.001 |
| Hemiplegia or paraplegia | 13 (1.6) | 34 (0.4) | <0.001 |
| Renal disease | 112 (13.7) | 428 (5.2) | <0.001 |
| Any malignancy, including leukemia and lymphoma | 147 (18) | 646 (8) | <0.001 |
| Diabetes with chronic complications | 92 (11.3) | 432 (5.3) | <0.001 |
| Skin ulcers | 122 (14.9) | 302 (3.7) | <0.001 |
| Moderate or severe liver disease | 28 (3.4) | 19 (0.2) | <0.001 |
| Metastatic solid tumor | 46 (5.6) | 59 (0.7) | <0.001 |
| HIV/AIDS | 11 (1.4) | 42 (0.5) | 0.003 |
| Other Selected Comorbidities | |||
| Non‐pain‐related | |||
| Substance abuse and nonopioid substance dependence | 215 (26.3) | 764 (9.4) | <0.001 |
| Opioid dependence | 105 (12.9) | 97 (1.2) | <0.001 |
| Endocarditis | 1 (0.1) | 9 (0.1) | 0.92 |
| Viral hepatitis | 106 (13) | 249 (3) | <0.001 |
| Alcoholic hepatitis | 3 (0.4) | 5 (0.1) | 0.005 |
| Non‐malignant pancreatic disease | 24 (2.9) | 49 (0.6) | <0.001 |
| Sexually transmitted disease | 12 (1.5) | 69 (0.8) | 0.07 |
| Herpes simplex | 7 (0.9) | 45 (0.6) | 0.27 |
| Skin infections/abscesses | 85 (10.4) | 286 (3.5) | <0.001 |
| Sleep apnea | 147 (18) | 652 (8) | <0.001 |
| Tobacco use disorder | 301 (36.8) | 1,266 (15.5) | <0.001 |
| PTSD | 221 (27.1) | 1,119 (13.7) | <0.001 |
| Bipolar disorder | 86 (10.5) | 239 (2.9) | <0.001 |
| ADHD | 7 (0.9) | 58 (0.7) | 0.64 |
| Schizophrenia | 36 (4.4) | 114 (1.4) | <0.001 |
| Anxiety disorder | 180 (22) | 681 (8.3) | <0.001 |
| OCD | 5 (0.6) | 19 (0.2) | 0.045 |
| Cardiovascular disease | 172 (21.1) | 764 (9.4) | <0.001 |
| Obesity | 150 (18.4) | 1,072 (13.1) | <0.001 |
| Pain‐related | |||
| Low back disorders | 380 (46.5) | 2,099 (25.7) | <0.001 |
| Other back/neck disorders | 214 (26.2) | 1,048 (12.8) | <0.001 |
| Neuropathic disorder | 170 (20.8) | 717 (8.8) | <0.001 |
| Fibromyalgia | 34 (4.2) | 157 (1.9) | <0.001 |
| Chronic headache | 88 (10.8) | 427 (5.2) | <0.001 |
| Burns | 4 (0.5) | 16 (0.2) | 0.089 |
| Active traumatic injury | 212 (26) | 869 (10.6) | <0.001 |
| Motor vehicle accident | 7 (0.9) | 14 (0.2) | <0.001 |
| PRESCRIPTION DRUG INFORMATION | |||
| Opioid use | 693 (84.8) | 4,936 (60.4) | <0.001 |
| BY ACTIVE INGREDIENT | |||
| Hydrocodone | 314 (38.4) | 2,633 (32.2) | <0.001 |
| Oxycodone | 305 (37.3) | 876 (10.7) | <0.001 |
| Morphine | 251 (30.7) | 334 (4.1) | <0.001 |
| Tramadol | 114 (14) | 1,428 (17.5) | 0.01 |
| Methadone | 107 (13.1) | 139 (1.7) | <0.001 |
| Codeine | 63 (7.7) | 561 (6.9) | 0.365 |
| Fentanyl | 49 (6) | 44 (0.5) | <0.001 |
| Hydromorphone | 38 (4.7) | 28 (0.3) | <0.001 |
| Oxymorphone | 1 (0.1) | 1 (0) | 0.04 |
| Buprenorphine | 0 (0) | 2 (0) | 0.66 |
| Othera | 2 (0.2) | 4 (0.1) | 0.04 |
| BY FORMULATION | |||
| Extended‐Release/Long‐Acting (ER/LA) | 369 (45.2) | 499 (6.1) | <0.001 |
| Not ER/LA | 633 (77.5) | 4,807 (58.5) | <0.001 |
| Proportion of opioids = ER/LAb | 0.25 (0.3) | <0.1 (0.2) | <0.001 |
| BY ROUTE | |||
| Oral | 692 (84.7) | 4,923 (60.3) | <0.001 |
| Parenteral | 6 (0.7) | 6 (0.1) | <0.001 |
| Transdermal | 48 (5.9) | 44 (0.5) | <0.001 |
| NUMBER OF OPIOID PRESCRIPTIONS DISPENSED, Mean (SD) | 6.8 (5.9) | 2.5 (3.4) | <0.001 |
| NUMBER OF UNIQUE OPIOID NDCs, Mean (SD) | 2.4 (1.9) | 0.9 (1.1) | <0.001 |
| MAXIMUM PRESCRIBED DAILY MED (mg), Mean (SD) | 98.7 (122.1) | 24.2 (48.4) | <0.001 |
| Maximum Prescribed Daily MED Group | |||
| 1–<20 | 35 (4.3) | 1,331 (16.3) | <0.001 |
| 20–<50 | 227 (27.8) | 2,614 (32) | |
| 50–<100 | 163 (20) | 718 (8.8) | |
| ≥100 | 268 (32.8) | 273 (3.3) | |
| Selected Nonopioid Drugs | 747 (91.4) | 5,905 (72.3) | <0.001 |
| Benzodiazepines | 336 (41.1) | 1,242 (15.2) | <0.001 |
| Antidepressants | 565 (69.2) | 2,886 (35.3) | <0.001 |
| Nonopioid analgesics | 556 (68.1) | 4,598 (56.3) | <0.001 |
| Muscle relaxants | 226 (27.7) | 1,288 (15.8) | <0.001 |
| Other Sedatives | 125 (15.3) | 609 (7.5) | <0.001 |
| Antipsychotics | 239 (29.3) | 772 (9.5) | <0.001 |
| Stimulants | 14 (1.7) | 51 (0.6) | <0.001 |
| ALL CAUSE HEALTH CARE UTILIZATION | |||
| Days of hospitalization, mean (SD) | 9.6 (22.9) | 1.1 (8) | <0.001 |
| Patients with ≥1 outpatient ED Visit | 534 (65.4) | 1,740 (21.3) | <0.001 |
| Patients with ≥1 outpatient office visit | 792 (96.9) | 7,333 (89.8) | <0.001 |
| Patients with ≥1 hospitalization | 396 (48.5) | 739 (9.1) | <0.001 |
| Patients with ≥1 prescription fill | 800 (97.9) | 7,561 (92.6) | <0.001 |
| Outpatient ED visits per patient, mean (SD) | 2 (2.6) | 0.4 (1) | <0.001 |
| Outpatient office visits per patient, mean (SD) | 23 (18.6) | 9.8 (11.3) | <0.001 |
| Hospitalizations per patient, mean (SD) | 1 (1.5) | 0.1 (0.5) | <0.001 |
| Pharmacy visits per patient, mean (SD) | 24.6 (15) | 12.9 (10.4) | <0.001 |
a
Other opioids included meperidine and pentazocine/naloxone.
b
Proportion of opioid prescriptions dispensed to a patient during baseline that contained an extended‐release/long‐acting formulation. Methadone is a long‐acting opioid.
Abbreviations: CCI = Charlson Comorbidity Index; ED = emergency department; ER = extended‐release; LA=long acting; MED = morphine equivalent dose; NDC = National Drug Code.