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Opioid Rx Frequently Issued for Nonspecific, Spinal Conditions

Spine, orthopedic disorders most prominent among categories of conditions linked to initial opioid Rx

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THURSDAY, Aug. 17, 2017 (HealthDay News) -- Within a cohort of patients insured through TRICARE, the most common diagnosis associated with initial opioid prescription is other ill-defined conditions, according to a research letter published online Aug. 16 in JAMA Surgery.

Andrew J. Schoenfeld, M.D., from Brigham and Women's Hospital in Boston, and colleagues queried the Military Health Data Repository to identify all patients insured through TRICARE who received a prescription for class II or III opioid analgesics and who were previously opioid naive. The authors assessed those who had received an opioid prescription for sustained opioid use.

The researchers identified 117,118 patients who met the criteria for sustained prescription opioid use. Only 0.7 percent received their initial opioid prescription following an inpatient encounter; 0.4 percent had undergone an inpatient procedure. For the entire cohort, other ill-defined conditions (30.6 percent) was the most common diagnosis associated with initial opioid prescription. Among patients treated in military facilities, lumbago was the most frequent diagnosis. In both military and civilian settings, spinal conditions were among the most frequent diagnoses. Spine and orthopedic disorders were the most prominent among specific categories of conditions associated with the initial opioid prescription.

"In this cohort, most of the diagnoses used to support the issue of an opioid prescription that led to sustained use were either nonspecific or associated with spinal or other conditions for which opioid administration is not considered standard of care," the authors write.

One author disclosed financial ties to Arbormetrix.

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