Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database
Postinjury pain is a well-known debilitating complication of spinal cord injury (SCI), often resulting in long-term, high-dose opioid use with the potential for dependence. There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI. To...
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| Veröffentlicht in: | Topics in spinal cord injury rehabilitation 2023-01, Vol.29 (1), p.118-130 |
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| creator | Wilkinson, Riley L Castillo, Camilo Herrity, April Wang, Dengzhi Sharma, Mayur Dietz, Nick Adams, Shawn Khattar, Nicholas Nuno, Miriam Drazin, Doniel Boakye, Maxwell Ugiliweneza, Beatrice |
| description | Postinjury pain is a well-known debilitating complication of spinal cord injury (SCI), often resulting in long-term, high-dose opioid use with the potential for dependence. There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI.
To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.
Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.
After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%,
< .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26-43). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.
Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI. |
| doi_str_mv | 10.46292/sci22-00026 |
| format | Article |
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To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.
Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.
After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%,
< .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26-43). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.
Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI.</description><identifier>ISSN: 1082-0744</identifier><identifier>EISSN: 1945-5763</identifier><identifier>DOI: 10.46292/sci22-00026</identifier><identifier>PMID: 36819927</identifier><language>eng</language><publisher>United States: Allen Press Inc</publisher><subject>Adult ; Analgesics, Opioid - therapeutic use ; Chronic obstructive pulmonary disease ; Drug overdose ; Generalized linear models ; Health care policy ; Health services utilization ; Hospitalization ; Hospitals ; Humans ; Hypotheses ; Medicaid ; Medicare ; Morphine ; Narcotics ; Opioid-Related Disorders - drug therapy ; Pain ; Patient Acceptance of Health Care ; Population ; Prescription drugs ; Rehabilitation ; Retrospective Studies ; Spinal Cord Injuries ; Substance use disorder</subject><ispartof>Topics in spinal cord injury rehabilitation, 2023-01, Vol.29 (1), p.118-130</ispartof><rights>2023 American Spinal Injury Association.</rights><rights>Copyright Allen Press Inc. Winter 2023</rights><rights>2023 American Spinal Injury Association 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-3a517b4e55d009bf6488e9e5f30e89d4c9d4951c3297c52fdda75d3e57c1b1ac3</citedby><cites>FETCH-LOGICAL-c412t-3a517b4e55d009bf6488e9e5f30e89d4c9d4951c3297c52fdda75d3e57c1b1ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9936895/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9936895/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36819927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilkinson, Riley L</creatorcontrib><creatorcontrib>Castillo, Camilo</creatorcontrib><creatorcontrib>Herrity, April</creatorcontrib><creatorcontrib>Wang, Dengzhi</creatorcontrib><creatorcontrib>Sharma, Mayur</creatorcontrib><creatorcontrib>Dietz, Nick</creatorcontrib><creatorcontrib>Adams, Shawn</creatorcontrib><creatorcontrib>Khattar, Nicholas</creatorcontrib><creatorcontrib>Nuno, Miriam</creatorcontrib><creatorcontrib>Drazin, Doniel</creatorcontrib><creatorcontrib>Boakye, Maxwell</creatorcontrib><creatorcontrib>Ugiliweneza, Beatrice</creatorcontrib><title>Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database</title><title>Topics in spinal cord injury rehabilitation</title><addtitle>Top Spinal Cord Inj Rehabil</addtitle><description>Postinjury pain is a well-known debilitating complication of spinal cord injury (SCI), often resulting in long-term, high-dose opioid use with the potential for dependence. There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI.
To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.
Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.
After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%,
< .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26-43). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.
Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI.</description><subject>Adult</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Drug overdose</subject><subject>Generalized linear models</subject><subject>Health care policy</subject><subject>Health services utilization</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Morphine</subject><subject>Narcotics</subject><subject>Opioid-Related Disorders - drug therapy</subject><subject>Pain</subject><subject>Patient Acceptance of Health Care</subject><subject>Population</subject><subject>Prescription drugs</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Spinal Cord Injuries</subject><subject>Substance use disorder</subject><issn>1082-0744</issn><issn>1945-5763</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkc1u1DAUhSMEomVgxxpZYsOCgH_iOGaBNJoCrVRUJDpry7FvWg8ZO9gO0vQp-shYaamAxfW1fD4f2fdU1UuC3zUtlfR9Mo7SGmNM20fVMZENr7lo2eOyx10RRNMcVc9S2hWCdBg_rY5Y2xEpqTiubi8mF5xFJzCBt-ANIO0tWqcUjNMZLDoFPeZrtNER0Da70d3o7IJfsE1IGTmPLqOe9-XYoO-T83osQrTozO_meEDfwjSPy50PaF3EQ3IJbZPzV-irjj8gJ6M9OtFZ9zrB8-rJoMcEL-77qtp-_nS5Oa3PL76cbdbntWkIzTXTnIi-Ac4txrIf2qbrQAIfGIZO2saUkpwYRqUwnA7WasEtAy4M6Yk2bFV9vPOd5n4P1oDPUY9qim6v40EF7dS_infX6ir8UlKW6UleDN7cG8Twc4aU1d4lA-OoPYQ5KSqEZE1Hy7qqXv-H7sIcyygWqhUlRsYK9faOMjGkFGF4eAzBaolaLVGrJeqCv_r7Aw_wn2zZb3z0pyA</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Wilkinson, Riley L</creator><creator>Castillo, Camilo</creator><creator>Herrity, April</creator><creator>Wang, Dengzhi</creator><creator>Sharma, Mayur</creator><creator>Dietz, Nick</creator><creator>Adams, Shawn</creator><creator>Khattar, Nicholas</creator><creator>Nuno, Miriam</creator><creator>Drazin, Doniel</creator><creator>Boakye, Maxwell</creator><creator>Ugiliweneza, Beatrice</creator><general>Allen Press Inc</general><general>American Spinal Injury Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>KB0</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230101</creationdate><title>Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database</title><author>Wilkinson, Riley L ; 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There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI.
To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.
Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.
After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%,
< .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26-43). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.
Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI.</abstract><cop>United States</cop><pub>Allen Press Inc</pub><pmid>36819927</pmid><doi>10.46292/sci22-00026</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1082-0744 |
| ispartof | Topics in spinal cord injury rehabilitation, 2023-01, Vol.29 (1), p.118-130 |
| issn | 1082-0744 1945-5763 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9936895 |
| source | MEDLINE; Allen Press Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Analgesics, Opioid - therapeutic use Chronic obstructive pulmonary disease Drug overdose Generalized linear models Health care policy Health services utilization Hospitalization Hospitals Humans Hypotheses Medicaid Medicare Morphine Narcotics Opioid-Related Disorders - drug therapy Pain Patient Acceptance of Health Care Population Prescription drugs Rehabilitation Retrospective Studies Spinal Cord Injuries Substance use disorder |
| title | Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database |
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