Opioid prescriptions for treating chronic abdominal pain doubled between 1997 and 2008
Although the number of outpatient visits for chronic abdominal pain (CAP) declined by almost a fifth from 1997–1998 to 2006–2008, visits during which an opioid was prescribed more than doubled, according to a new study. CAP is a common reason for outpatient visits, and its management is often a challenge for clinicians. Nevertheless, opioid analgesics have not been proven effective for treating CAP and have been linked to drug misuse and gastrointestinal symptoms, including worsening pain. Based on two national surveys, each conducted a decade apart (the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey), the researchers estimated that there were 14.8 million outpatient visits (2,464 per 100,000 population) for CAP from 1997 through 1999, which decreased by 17.6 percent (to 12.2 million outpatients visits, or 1,863 per 100,000 population) for 2006 through 2008. Over the same period, the proportion of visits for CAP in which the patient received at least one opioid prescription increased from 5.9 percent during 1997–1999 to 12.2 percent during 2006–2008.
The likelihood of receiving an opioid prescription was highest for patients 25 to 50 years old (4.8 times more likely than for ages 18 to 24 years). In contrast, opioid prescriptions were least commonly given to uninsured patients (12 percent of the rate for privately insured patients) and blacks (34 percent of the rate for whites). The researchers call for more studies to better understand the reasons for and consequences of these trends.
This study was funded in part by the Agency for Healthcare Research and Quality (HS19468). More details are in "Increasing frequency of opioid prescriptions for CAP in US outpatient clinics," by Spencer D. Dorn, M.D., M.P.H., Patrick D. Meek, D.Pharm., M.S.P.H., and Nilay D. Shah, Ph.D., in the December 2011 Clinical Gastroenterology and Hepatology 9(12), pp. 1078-1085.