Table 1:
Characteristics of ED visits for opioid naïve patients who received an opioid prescription
| Converted to Persistent or High-Risk Use N = 3,207 (13.7%) |
Did not convert N = 20,174 (86.3%) |
|
|---|---|---|
| Patient demographics | ||
| Age (yrs) – N(%) | ||
| 13–17 | 78 (2.4) | 2,468 (12.2) |
| 18–39 | 1,826 (56.9) | 11,616 (57.6) |
| 40–64 | 1,303 (40.6) | 6,090 (30.2) |
| Female sex – N(%) | 1,783 (55.6) | 11,676 (57.9) |
| Race-ethnicity – N(%) | ||
| White | 2,215 (69.1) | 12,288 (60.9) |
| Hispanic | 302 (9.4) | 2,668 (13.2) |
| Black | 243 (7.6) | 1,738 (8.6) |
| American Indian/Alaska Native | 110 (3.4) | 582 (2.9) |
| Asian/Hawaiian or other Pacific Islander | 67 (2.1) | 714 (3.5) |
| Other/unknown | 270 (8.4) | 2,184 (10.8) |
| Insurance | ||
| Qualified for Medicaid under disability – N(%) | 858 (26.8) | 3,532 (17.5) |
| Qualified for Medicaid by income under expansion – N(%) | 916 (28.6) | 4,900 (24.3) |
| Coverage type – N(%) | ||
| Managed Care | 2,928 (91.3) | 18,515 (91.8) |
| Fee-for-service | 279 (8.7) | 1,659 (8.2) |
| History of physical health conditions – N(%) | ||
| Skeletal and connective | 1,086 (33.9) | 4,212 (20.9) |
| Cardiovascular | 759 (23.7) | 3,039 (15.1) |
| Pulmonary | 582 (18.1) | 2,597 (12.9) |
| Gastrointestinal | 541 (16.9) | 2,260 (11.2) |
| Skin | 432 (13.5) | 2,357 (11.7) |
| Diabetes | 282 (8.8) | 1,180 (5.8) |
| Nervous system | 230 (7.2) | 845 (4.2) |
| Genital | 219 (6.8) | 1,046 (5.2) |
| Pregnancy | 172 (5.4) | 1,261 (6.3) |
| Metabolic | 174 (5.4) | 676 (3.4) |
| Infectious | 193 (6.0) | 672 (3.3) |
| Renal | 124 (3.9) | 481 (2.4) |
| Hematologic | 52 (1.6) | 210 (1.0) |
| Other1 | 66 (2.1) | 400 (2.0) |
| History of substance use disorder – N(%) | ||
| Opioids | 81 (2.5) | 212 (1.1) |
| Cannabis | 69 (2.2) | 313 (1.6) |
| Amphetamines | 74 (2.3) | 288 (1.4) |
| Tobacco | 477 (14.9) | 1,860 (9.2) |
| Other2 | 261 (8.1) | 1,066 (5.3) |
| History of other behavioral health disorder – N(%) | ||
| Anxiety | 730 (22.8) | 2,863 (14.2) |
| Dysthymia or other depression | 579 (18.1) | 2,467 (12.2) |
| Major depression | 351 (10.9) | 1360 (6.7) |
| Alcohol disorder | 287 (8.9) | 1,100 (5.5) |
| Bipolar disorder | 189 (5.9) | 779 (3.9) |
| Disorders originating in childhood | 108 (3.4) | 820 (4.1) |
| Schizophrenia or other non-mood disorder | 79 (2.5) | 343 (1.7) |
| Other3 | 744 (23.2) | 2,981 (14.8) |
| Pain-related or injury diagnoses at visit – N(%) | ||
| Any pain or injury diagnosis | 2,080 (64.9) | 11,885 (58.9) |
| Arthritis/joint pain | 479 (14.9) | 2,135 (10.6) |
| Back pain | 488 (15.2) | 2,316 (11.5) |
| Non-traumatic dental pain | 331 (10.3) | 1967 (9.8) |
| Neck pain | 190 (5.9) | 909 (4.5) |
| Kidney stone | 87 (2.7) | 609 (3.0) |
| Injury | 1,222 (38.1) | 7,600 (37.7) |
| Other4 | 210 (6.5) | 1,107 (5.5) |
| Medications | ||
| History of benzodiazepine use – N(%) | 115 (3.6) | 302 (1.5) |
| Total MME prescribed at visit – N(%) | ||
| under 150 | 2416 (75.3) | 17029 (84.4) |
| 150–350 | 665 (20.7) | 2933 (14.5) |
| 350 and over | 126 (3.9) | 212 (1.1) |
Notes: history of physical, behavioral, and substance use disorders, as well as history of benzodiazepine use, were evaluated using the prior year of claims data. Pain-related and injury diagnoses were assessed at the index visit, and total prescribed MME was evaluated for prescriptions written within 1 day of the index visit.
1.
eye, cerebrovascular, and developmental disability
2.
barbiturate, cocaine, hallucinogen, and antidepressant abuse, and miscellaneous
3.
personality disorder, adjustment disorder, and miscellaneous
4.
gallstone, headache, and miscellaneous