Abstract
OBJECTIVES: About 20% of the United States (US) population is affected by non-cancer pain conditions (NCPCs). While prescription opioids are used commonly for NCPCs, their use is controversial due to the issues concerning their safety. We sought to: 1) characterize opioid use in US adults with NCPCs (back/neck pain, arthritis, headache/migraine and musculoskeletal pain/neuralgia and 2) estimate direct healthcare expenditures associated with opioid use in NCPCs. METHODS: This retrospective cross-sectional study used data from the 2014 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults with one or more recorded observations of NCPCs (N= 7,497). Chi-square tests were used to examine unadjusted subgroup differences and a multivariable logistic regression model was used to assess the association of opioid use and the type of NCPCs. To compare average healthcare expenditures between opioid users and non-users, we matched the two groups using propensity score matching, and also used generalized linear model (GLM) to adjust for other factors. RESULTS: A majority of individuals with NCPC reported arthritis (N=5,266, 70.5%) and 27.4% individuals reported using prescription opioids. Individuals with musculoskeletal pain/neuralgia were more likely to use opioids than individuals with back/neck pain (OR 1.3, 95% CI 1.01-1.64). After matching, opioid users had more than twice the total average healthcare expenditures than non-users ($13,956 vs. $6,140). Results from the GLM model showed that the total healthcare expenditures for those using opioids were significantly higher by $5,042 as compared to non-users (P< 0.001). Further, those with arthritis and musculoskeletal pain/ neuralgia had significantly higher healthcare expenditures than those with back/ neck pain. CONCLUSIONS: The majority of opioid use was found among individuals with musculoskeletal pain/neuralgia. The total average healthcare expenditures were significantly higher among opioid users, highlighting the need to better evaluate the appropriate use of opioids for NCPCs in clinical practice.