scholarly journals Social isolation, residential stability, and opioid use disorder among old medicare beneficiaries: Metropolitan and non-metropolitan county comparison

2021 ◽  
pp. 114605
Author(s):  
Tse-Chuan Yang ◽  
Carla Shoff ◽  
Seulki Kim
Keyword(s):  
Social Isolation ◽  
Opioid Use Disorder ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Residential Stability ◽  
Metropolitan County

scholarly journals Medically Treated Opioid Overdoses Among the U.S. Elderly: Trends and Correlates

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Peter Treitler ◽  
Stephen Crystal ◽  
Richard Hermida ◽  
Jennifer Miles
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Chronic Obstructive ◽  
Medicare Beneficiaries ◽  
Older Individuals ◽  
Opioid Use ◽  
Policy And Practice ◽  
Obstructive Pulmonary Disease

Abstract High rates of opioid prescribing and comorbid medical conditions increase risk of overdose among older adults. As the US population ages and the rates of opioid use disorder (OUD) increase in the elderly population, there is a need to characterize trends and correlates of overdose in order to more effectively target policy and practice. Using a ~40% random sample of 2015-2017 Medicare beneficiaries ages 65 and older with Part D pharmacy coverage, this study examined medically treated opioid overdoses among US older adults. The sample included 13-14 million beneficiaries per year. The rate of medically treated opioid overdoses among elderly Medicare beneficiaries increased by 15% from 6 per 10,000 in 2015 to 6.9 per 10,000 in 2017. Those with overdose were disproportionately female (63%), non-Hispanic white (83%), with diagnoses of pain conditions (96%), with diagnoses of major depression (63%), and with high rates of conditions that decrease respiratory reserve such as chronic obstructive pulmonary disease. 13% had co-occurring diagnosed alcohol use disorder, 36% were diagnosed with opioid dependence or abuse, and 12% were diagnosed with hepatitis C. Older individuals with overdose represent a complex mix of risk factors; identifying those most at risk (as well as those who have very low risk, whose pain management may be compromised by overly-rigid interpretation of opioid use guidelines) is key in order to address multiple risks, balancing risk reduction with appropriate pain management.

scholarly journals Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer

2020 ◽  
Author(s):  
Andrew W Roberts ◽  
Samantha Eiffert ◽  
Elizabeth M Wulff-Burchfield ◽  
Stacie B Dusetzina ◽  
Devon K Check
Keyword(s):  
Prostate Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Opioid Therapy ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Medicare Data ◽  
End Results

Abstract Background Despite high rates of opioid therapy, evidence about the risk of preventable opioid harms among cancer survivors is underdeveloped. Our objective was to estimate the odds of opioid use disorder (OUD) and overdose following breast, colorectal, or prostate cancer diagnosis among Medicare beneficiaries. Methods We conducted a retrospective cohort study using 2007-2014 Surveillance, Epidemiology, and End Results-Medicare data for cancer survivors with a first cancer diagnosis of stage 0-III breast, colorectal, or prostate cancer at age 66-89 years between 2008 and 2013. Cancer survivors were matched to up to 2 noncancer controls on age, sex, and Surveillance, Epidemiology, and End Results region. Using Firth logistic regression, we estimated adjusted 1-year odds of OUD or nonfatal opioid overdose associated with a cancer diagnosis. We also estimated adjusted odds of OUD and overdose separately and by cancer stage, prior opioid use, and follow-up time. Results Among 69 889 cancer survivors and 125 007 controls, the unadjusted rates of OUD or nonfatal overdose were 25.2, 27.1, 38.9, and 12.4 events per 10 000 patients in the noncancer, breast, colorectal, and prostate samples, respectively. There was no association between cancer and OUD. Colorectal survivors had 2.3 times higher odds of opioid overdose compared with matched controls (adjusted odds ratio = 2.33, 95% confidence interval  = 1.49 to 3.67). Additionally, overdose risk was greater in those with more advanced disease, no prior opioid use, and preexisting mental health conditions. Conclusions Opioid overdose was a rare, but statistically significant, outcome following stage II-III colorectal cancer diagnosis, particularly among previously opioid-naïve patients. These patients may require heightened screening and intervention to prevent inadvertent adverse opioid harms.

scholarly journals Medically Assisted Treatment of Opioid Use Disorder Among Elderly and Non-Elderly Medicare Beneficiaries

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Jennifer Miles ◽  
Stephen Crystal ◽  
Peter Treitler ◽  
Richard Hermida
Keyword(s):  
Older Adults ◽  
Addiction Treatment ◽  
Elderly Population ◽  
Ethnic Disparities ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Close Monitoring ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Racial Ethnic

Abstract Although medication for addiction treatment (MAT) is known to be the most effective treatment for opioid use disorder (OUD), these medications are widely underutilized, especially among older adults and racial/ethnic minorities. Of the three main MAT modalities, Medicare covered buprenorphine and naltrexone in 2017; methadone was not covered until 2020. We examined MAT prescribing among elderly compared with non-elderly Medicare beneficiaries. Our sample was drawn from a ~40% random sample of 2017 Medicare beneficiaries with Part D coverage and was comprised of elderly beneficiaries (age 65+) with OUD (N=112,314) or who experienced opioid poisoning (N=9,657), and non-elderly Medicare beneficiaries (the Medicare disability population, age 0-64) with OUD (N=161,423) or opioid poisoning (N=13,591). MAT was underutilized in both Medicare populations, but especially in the elderly population. Of elderly beneficiaries with OUD, 5.1% and 0.8% were prescribed buprenorphine and naltrexone, respectively, compared to 15.5% and 2.3% among non-elderly. Among elderly beneficiaries with opioid poisoning, 3.1% and 0.8% were prescribed buprenorphine and naltrexone, respectively, compared to 10.1% and 3.2% in the non-elderly population. Sharp racial/ethnic disparities were identified within each age group. These findings highlight the need to expand access to MAT for Medicare beneficiaries, particularly older adults among whom underutilization is pronounced. Several recent Medicare policy changes have sought to address this issue, but continuing efforts and close monitoring are warranted in an effort to dramatically increase rates of treatment for elderly with opioid use disorder.

scholarly journals Using machine learning to predict risk of incident opioid use disorder among fee-for-service Medicare beneficiaries: A prognostic study

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0235981
Author(s):  
Wei-Hsuan Lo-Ciganic ◽  
James L. Huang ◽  
Hao H. Zhang ◽  
Jeremy C. Weiss ◽  
C. Kent Kwoh ◽  
...  
Keyword(s):  
Machine Learning ◽  
Opioid Use Disorder ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Opioid Use

Gaps In Access To Opioid Use Disorder Treatment For Medicare Beneficiaries

2020 ◽  
Vol 39 (2) ◽  
pp. 233-237
Author(s):  
Samantha J. Harris ◽  
Amanda J. Abraham ◽  
Christina M. Andrews ◽  
Courtney R. Yarbrough
Keyword(s):  
Opioid Use Disorder ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Disorder Treatment

Initiation of Long-Acting Opioids Following Hospital Discharge Among Medicare Beneficiaries

2021 ◽  
Author(s):  
Bhushan R Deshpande ◽  
Ellen P McCarthy ◽  
Yoojin Jung ◽  
Timothy S Anderson ◽  
Shoshana J Herzig
Keyword(s):  
Hospital Discharge ◽  
Hospice Care ◽  
Opioid Use Disorder ◽  
High Dose ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Short Acting ◽  
Long Acting

Guidelines recommend against initiating long-acting opioids during acute hospitalization, owing to higher risk of overdose and morbidity compared to short-acting opioid initiation. We investigated the incidence of long-acting opioid initiation following hospitalization in a retrospective cohort of Medicare beneficiaries with an acute care hospitalization in 2016 who were ≥65 years old, did not have cancer or hospice care, and had not filled an opioid prescription within the preceding 90 days. Among 258,193 hospitalizations, 47,945 (18.6%) were associated with a claim for a new opioid prescription in the week after hospital discharge: 817 (0.3%) with both short- and long-acting opioids, 125 (0.1%) with long-acting opioids only, and 47,003 (18.2%) with short-acting opioids only. Most long-acting opioid claims occurred in surgical patients (770 out of 942; 81.7%). Compared with beneficiaries prescribed short-acting opioids only, beneficiaries prescribed long-acting opioids were younger, had a higher prevalence of diseases of the musculoskeletal system and connective tissue, and had more known risk factors for opioid-related adverse events, including anxiety disorders, opioid use disorder, prior long-term high-dose opioid use, and benzodiazepine co-prescription. These findings may help target quality-improvement initiatives.

L'esperienza clinica con Levometadone nel trattamento del disturbo da uso di oppiacei

MISSION ◽  
2019 ◽  
pp. 54-57
Author(s):  
Marco Riglietta ◽  
Paolo Donadoni ◽  
Grazia Carbone ◽  
Caterina Pisoni ◽  
Franca Colombi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Real Life ◽  
Opioid Use Disorder ◽  
Racemic Mixture ◽  
Opioid Use ◽  
The Real ◽  
New Formulation

In Italy, at the end of the 1970s, methadone hydrochloride was introduced for the treatment of opioid use disorder, in the form of a racemic mixture consisting of levomethadone and dextromethadone.In 2015 Levometadone was introduced, a new formulation marketed in Italy for the treatment of opioid use disorder in 2015.The article aims to bring the experience of an Italian Addiction Centre back to the use of this new formulation in the "real life" analyzing the efficacy, the trend of adverse events and pharmacological iterations in a context in which the treated population often uses besides the opiates, cocaine and alcohol, are burdened by a relevant physical and psychic comorbidity and frequently have a prescribed polypharmacy.

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