Observational studyJournal of general internal medicine2018
Decline in Prescription Opioids Attributable to Decreases in Long-Term Use: A Retrospective Study in the Veterans Health Administration 2010-2016.
Observational study in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Who cites it
37 citing papers in PubMed.
- Tracking implementation strategies in the randomized rollout of a Veterans Affairs national opioid risk management initiative.Implementation science : IS · 2020Trial
- Trial
- Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors.The journal of spinal cord medicine · 2025Article
- Demographic, Social, Behavioral, and Clinical Characteristics Associated with Long-Term Opioid Therapy and Any Opioid Prescription in High-Risk VA Patients.Journal of general internal medicine · 2025Article
- Trends of opioid use following anterior cervical discectomy and fusion: A 10-year longitudinal study of the Veterans Health Administration.North American Spine Society journal · 2025Article
- An updated view on the influence of initial opioid prescription characteristics on long-term opioid use among opioid naïve patients.Drug and alcohol dependence · 2024Article
- Prescription opioid dispensing patterns among patients with schizophrenia or bipolar disorder.BMC psychiatry · 2024Observational
- Perspectives of homeless veterans living with substance use disorders (SUD) and mental illness.Heliyon · 2023Article
- The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder.Journal of clinical medicine · 2023Article
- Patient and Provider Perspectives on Benefits and Harms of Continuing, Tapering, and Discontinuing Long-Term Opioid Therapy.Journal of general internal medicine · 2023Article
- Prescription Opioid Misuse and Suicidal Behaviors Among US Veterans: A Cross-Sectional Study from the 2015-2019 National Survey on Drug Use and Health.The journal of behavioral health services & research · 2023Article
- Development of a potential opioid misuse measure from administrative dispensing data and contrasting opioid misuse among individuals on long-term tramadol, long-term short-acting hydrocodone or long-term short-acting oxycodone therapy in Arkansas.Current medical research and opinion · 2022Article
- Adapting the Eliminating Medications Through Patient Ownership of End Results Protocol to Promote Benzodiazepine Cessation Among US Military Veterans: Focus Group Study With US Military Veterans and National Veterans Health Administration Leaders.Journal of medical Internet research · 2022Article
- Transition from Military Service: Mental Health and Well-being Among Service Members and Veterans with Service-connected Disabilities.The journal of behavioral health services & research · 2022Article
- Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission.Lancet (London, England) · 2022Review
- Article
- Identifying individuals with opioid use disorder: Validity of International Classification of Diseases diagnostic codes for opioid use, dependence and abuse.Drug and alcohol dependence · 2021Article
- Treatment Preferences for Chronic Low Back Pain: Views of Veterans and Their Providers.Journal of pain research · 2021Article
- Association Between Opioid Dose Reduction Against Patients' Wishes and Change in Pain Severity.Journal of general internal medicine · 2020Observational
- Opioid Discontinuation Among Patients Receiving High-Dose Long-Term Opioid Therapy in the Veterans Health Administration.Journal of general internal medicine · 2020Observational
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproved understanding of temporal trends in short- and long-term opioid prescribing may inform efforts to curb the opioid epidemic.
objectiveTo characterize the prevalence of short- and long-term opioid prescribing in the Veterans Health Administration (VHA) from 2010 to 2016.
designObservational cohort study using VHA databases.
participantsAll patients receiving at least one outpatient prescription through the VHA during calendar years 2010 through 2016. MAIN MEASURES: Prevalence of opioid use from 2010 through 2016, stratified by short-term, intermediate-term, and long-term use. Temporal trends in discontinuation among existing long-term users and initiation of new long-term use and the net impact on rates of long-term opioid use. Relative likelihood of transitioning to long-term opioid use contrasted with use patterns in the prior year. KEY
resultsThe prevalence of opioid prescribing was 20.8% in 2010, peaked at 21.2% in 2012, and declined annually to 16.1% in 2016. Between 2010 and 2016, reductions in long-term opioid prescribing accounted for 83% of the overall decline in opioid prescription fills. Comparing data from 2010-2011 to data from 2015-2016, declining rates in new long-term use accounted for more than 90% of the decreasing prevalence of long-term opioid use in the VHA, whereas increases in cessation among existing long-term users accounted for less than 10%. The relative risk of transitioning to long-term use during 2016 was 6.5 (95% CI: 6.4, 6.7) among short-term users and 35.5 (95% CI: 34.8, 36.3) among intermediate users, relative to patients with no opioid prescriptions filled during 2015.
conclusionsOpioid prescribing trends followed similar trajectories in VHA and non-VHA settings, peaking around 2012 and subsequently declining. However, changes in long-term opioid prescribing accounted for most of the decline in the VHA. Recent VA opioid initiatives may be preventing patients from initiating long-term use. This may offer valuable lessons generalizable to other healthcare systems.
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