Table 3.
Unadjusted and adjusted hazard ratios for all-cause mortality associated with exposure to incident daily prescription opioid supply versus non-daily incident prescription opioid supply among insured adults in the United States, 2010-2015 (N=4,054,417)
| Daily opioid supply | Non-daily opioid supply | Overall | |
|---|---|---|---|
| n=111,383 | n=3,943,034 | n=4,054,417 | |
| Deaths, n (%) | 2,253 (2.02) | 13,377 (0.34) | 15,630 (0.39) |
| Person-years of observation | 90,624.40 | 3,199,133.00 | 3,289,758.00 |
| Unadjusted hazard ratio (95% CI) | 5.95 (5.69, 6.22) | Reference | |
| Adjusted hazard ratio (95% CI)a | |||
| Overall | 1.94 (1.84, 2.04) | Reference | |
| MME category (mg/day) | |||
| Low dose (< 90) | 1.88 (1.78, 1.98) | Reference | |
| High dose (90+) | 2.37 (1.92, 2.94) | Reference | |
| Age category (years) | |||
| < 65 years | 1.86 (1.78, 1.96) | Reference | |
| 65+ | 1.70 (1.60, 1.80) | Reference | |
Abbreviations: CI=confidence interval; MME=morphine milligram equivalent
Model adjusted for differences in age, sex, US census region, index year, type of insurance, type of health plan, Charlson comorbidity index, substance use disorders (alcohol, smoking, opioid overdose), surgical procedure, pregnancy-related conditions, fracture and strains, pain conditions (headache, neck and jaw pain, back pain, abdominal pain, fibromyalgia), measured at baseline and index periods, and opioid use disorder diagnosis, psychiatric medications (benzodiazepines, antidepressants, gabapentin), number of opioid providers and average daily prescription opioid dose during the index period.