ArticlePain medicine (Malden, Mass.)2021
Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain.
Article in Pain medicine (Malden, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Differences in the use of pharmacologic and nonpharmacologic treatments among patients with chronic low back pain between 2017 and 2021: A cross-sectional study of commercial claims.The journal of pain · 2026Article
- Bidirectional relationships between pain and alcohol use among older adults: a scoping review.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- A cost-utility analysis of pharmacopuncture versus physiotherapy for chronic low back pain: A multicenter, pragmatic randomized controlled trial.Integrative medicine research · 2025Article
- Pain when it "counts": hurdle analysis of clinical pain ratings improves data model performance.Pain reports · 2025Article
- Association Between Spinal Manipulative Therapy for Low Back Pain With or Without Sciatica and Opioid Use Disorder: A Retrospective Cohort Study.Health science reports · 2025Article
- Pain, comorbidities, and clinical decision-making: conceptualization, development, and pilot testing of the Pain in Aging, Educational Assessment of Need instrument.Frontiers in pain research (Lausanne, Switzerland) · 2024Article
- Diagnostic rate estimation from Medicare records: Dependence on claim numbers and latent clinical features.Journal of biomedical informatics · 2023Article
- Prevalence and predictors of musculoskeletal health complaints among sedentary, monotonous urban workers: A survey in Bangladesh.PloS one · 2023Article
- Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveLow back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race.
designCross-sectional study of a random national sample. SUBJECTS: Older adults including 1,477,594 U.S. Medicare Part B beneficiaries.
methodsBayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments.
resultsLBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol.
conclusionsOlder adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.
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