Table 2.
Odds of early and long-term opioid use by initial provider
| Early use, OR (95% CI) | Long-term, OR (95% CI) | ||
| Initial provider | PT (n=3499) | 0.15 (0.13 to 0.17) | 0.27 (0.15 to 0.48) |
| DC (n=50 014) | 0.10 (0.09 to 0.10) | 0.22 (0.18 to 0.26) | |
| Acupuncture (n=1839) | 0.09 (0.07 to 0.12) | 0.07 (0.01 to 0.48) | |
| Ortho (n=9335) | 0.63 (0.60 to 0.67) | 1.10 (0.92 to 1.30) | |
| Emerg Med (n=8746) | 2.66 (2.54 to 2.78) | 0.92 (0.77 to 1.10) | |
| Neurosgn (n=578) | 0.58 (0.47 to 0.71) | 1.50 (0.88 to 2.58) | |
| MD other (n=4422) | 0.50 (0.46 to 0.54) | 2.03 (1.70 to 2.41) | |
| Rehab (n=3246) | 0.54 (0.49 to 0.59) | 1.78 (1.40 to 2.26) | |
| Age (years) | 45–64 vs 18–44 | 1.07 (1.05 to 1.10) | 1.32 (1.19 to 1.46) |
| 65–74 vs 18–44 | 0.89 (0.82 to 0.97) | 0.79 (0.54 to 1.15) | |
| 75+ vs 18–44 | 0.80 (0.72 to 0.89) | 0.67 (0.45 to 1.00) | |
| Sex/gender | Female vs male | 0.83 (0.81 to 0.85) | 0.82 (0.76 to 0.89) |
| Race | Asian vs white | 0.49 (0.46 to 0.52) | 0.29 (0.20 to 0.42) |
| Black vs white | 0.90 (0.87 to 0.94) | 0.87 (0.76 to 0.99) | |
| Hispanic vs white | 0.79 (0.76 to 0.82) | 0.69 (0.59 to 0.81) | |
| Unknown vs white | 0.84 (0.79 to 0.89) | 0.65 (0.51 to 0.83) | |
| Region | Midwest vs Northeast | 0.78 (0.75 to 0.81) | 0.74 (0.64 to 0.87) |
| South vs Northeast | 1.11 (1.08 to 1.14) | 1.22 (1.11 to 1.34) | |
| West vs Northeast | 1.01 (0.97 to 1.04) | 1.17 (1.02 to 1.34) | |
| Insurance type | Medicare <65 years vs commercial insurance | 0.98 (0.89 to 1.08) | 3.77 (3.19 to 4.46) |
| Medicare ≥65 years vs commercial insurance | 0.98 (0.89 to 1.08) | 2.24 (1.54 to 3.26) | |
| Comorbidities | Anxiety | 1.05 (1.01 to 1.09) | 1.46 (1.30 to 1.63) |
| Bipolar disorder | 1.11 (1.01 to 1.21) | 1.41 (1.13 to 1.76) | |
| Depression | 1.11 (1.07 to 1.15) | 1.55 (1.39 to 1.73) | |
| Dementia | 0.80 (0.70 to 0.92) | 0.99 (0.73 to 1.36) | |
| ADHD | 0.87 (0.80 to 0.95) | 1.00 (0.75 to 1.32) | |
| Alcohol use disorder | 1.08 (0.98 to 1.20) | 1.28 (0.98 to 1.66) | |
| Substance use disorder | 1.06 (0.93 to 1.22) | 2.34 (1.76 to 3.10) | |
| Fibromyalgia/chronic pain/fatigue | 0.96 (0.92 to 1.01) | 1.92 (1.71 to 2.16) | |
| PTSD | 0.84 (0.69 to 1.03) | 1.16 (0.77 to 1.77) | |
| Psychotic disorder | 0.86 (0.74 to 0.99) | 0.76 (0.55 to 1.05) | |
| Elixhauser physical | 1.07 (1.06 to 1.08) | 1.24 (1.21 to 1.27) |
The following variables were all included in the regression: age, sex/gender, race/ethnicity, insurance, Elixhauser, which included physical comorbidities and mental health comorbidities. PCP is the reference group (n=114 782); adjusted for race/ethnicity, sex/gender, region and insurance type. Two additional initial providers—other non-MD (eg, physician assistants, advance practice nurses) and radiologist—were included in the analyses but not reported in this table.
*P<0.01.
ADHD, attention deficit hyperactivity disorder; DC, chiropractor; Emerg Med, emergency medicine physician; MD other, other physician; Neurosgn, neurosurgeon; Ortho, orthopaedic surgeon; PCP, primary care physician; PT, physical therapy; PTSD, post-traumatic stress disorder; Rehab, rehab physician.