Table 2.
Individual and County Characteristics Associated with Naloxone Co-prescribing During Long-term Opioid Treatment Episodes 2017–2018
| N of episodes with naloxone co-prescribing | Unadjusted rate of long-term opioid treatment episodes with naloxone co-prescribed (%) | aOR(95%CI) | |
|---|---|---|---|
| Total | 136,870 | 2.3 | -- |
| Gender | |||
| Female | 80,721 | 2.2 | REF |
| Male | 56,149 | 2.3 | 1.00 (0.99, 1.01) |
| Age cohort | |||
| 12-17 | 184 | 2.1 | 0.84 (0.72, 0.98) |
| 18.25 | 1407 | 2.1 | 0.91 (0.85, 0.96) |
| 26-35 | 9995 | 2.7 | REF |
| 36-45 | 20,548 | 2.9 | 1.05 (1.02, 1.08) |
| 46-55 | 34,607 | 2.9 | 1.04 (1.01, 1.06) |
| 56-65 | 39,934 | 2.5 | 0.93 (0.90, 0.95) |
| 66+ | 30,195 | 1.4 | 0.59 (0.58, 0.61) |
| Primary opioid episode payer | |||
| Medicare | 55,934 | 2.3 | 1.48 (1.46, 1.51) |
| Medicaid | 30,241 | 3.7 | 1.87 (1.84, 1.90) |
| Commercial | 33,309 | 2.0 | REF |
| Cash | 3083 | 1.4 | 0.77 (0.74, 0.80) |
| Other | 14,303 | 1.6 | 0.81 (0.79, 0.83) |
| Concomitant benzodiazepine | |||
| Yes | 28,630 | 3.5 | 1.12 (1.10, 1.14) |
| No | 108,240 | 2.1 | REF |
| High-dose episode | |||
| Yes | 39,809 | 7.7 | 3.19 (3.15, 3.23) |
| No | 97,061 | 1.8 | REF |
| Prescriber specialty | |||
| PCP adult | 35,534 | 1.2 | REF |
| Pain specialist/anesthesia | 48,970 | 3.8 | 2.47 (2.43, 2.51) |
| PA/NP | 42,969 | 3.7 | 2.29 (2.26, 2.33) |
| Oncology | 3524 | 2.2 | 1.06 (1.02, 1.10) |
| Other | 5873 | 1.0 | 0.92 (0.89, 0.95) |
| Multiple opioid prescribers | |||
| Yes | 102,609 | 2.9 | 1.40 (1.38, 1.41) |
| No | 34,261 | 1.3 | REF |
| County overdose rate quartile | |||
| 1st quartile (lowest OD rate) | 24,707 | 1.6 | REF |
| 2nd quartile | 34,059 | 2.2 | 1.18 (1.16, 1.21) |
| 3rd quartile | 42,675 | 2.8 | 1.24 (1.21, 1.26) |
| 4th quartile (highest OD rate) | 35,429 | 2.3 | 1.13 (1.10, 1.15) |
| County poverty rate | |||
| 1st quartile (lowest poverty rate) | 35,931 | 2.4 | 0.92 (0.90, 0.94) |
| 2nd quartile | 36,825 | 2.5 | 1.01 (0.99, 1.03) |
| 3rd quartile | 32,201 | 2.1 | 0.96 (0.94, 0.98) |
| 4th quartile (highest poverty rate) | 31,913 | 2.1 | REF |
| County rural-urban status (RUCC) | |||
| Metropolitan | 120,960 | 2.4 | REF |
| Rural adjacent | 10,188 | 1.7 | 0.85 (0.83, 0.87) |
| Rural remote | 5722 | 1.5 | 0.78 (0.76, 0.81) |
| Health professional shortage area | |||
| No | 133,689 | 2.3 | REF |
| Yes | 3181 | 1.5 | 0.85 (0.81, 0.88) |
The model also includes state fixed effects and controls for log of the episode days. Standard errors are adjusted for individual-level clustering