Trends in Prescription Analgesic Use Among Adults With Musculoskeletal Conditions in the United States, 1999-2016

Stokes, Andrew; Berry, Kaitlyn M.; Hempstead, Katherine; Lundberg, Dielle J.; Neogi, Tuhina

doi:10.1001/jamanetworkopen.2019.17228

Cited by 37 publications

(33 citation statements)

References 42 publications

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“…Our results are consistent with studies that show opioids are commonly prescribed for acute and chronic musculoskeletal pain 41‐43 . However, the prevalence of opioid use and opioid use disorder among this construction cohort is much higher than other populations.…”

Section: Discussionsupporting

confidence: 91%

Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data

Buckner‐Petty¹,

Evanoff²,

Gage³

2020

American J Industrial Med

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Background: Construction workers have high rates of work-related musculoskeletal disorders, which lead to frequent opioid use and opioid use disorder (OUD). This paper quantified the incidence of opioid use and OUD among construction workers with and without musculoskeletal disorders. Methods: We conducted a retrospective study using union health claims from January 2015 to June 2018 from 19,909 construction workers. Claims for diagnoses of chronic musculoskeletal disorders, acute musculoskeletal injuries, musculoskeletal surgery, and other conditions were linked to new opioid prescriptions. We examined the effects of high doses (≥50 morphine mg equivalents per day), large supply (more than 7 days per fill), long-term opioid use (60 or more days supplied within a calendar quarter), and musculoskeletal disorders, on the odds of a future OUD. Results: There were high rates (42.8% per year) of chronic musculoskeletal disorders among workers, of whom 24.1% received new opioid prescriptions and 6.3% received long-term opioid prescriptions per year. Workers receiving opioids for chronic musculoskeletal disorders had the highest odds of future OUD: 4.71 (95% confidence interval 3.09-7.37); workers prescribed long-term opioids in any calendar quarter had a nearly 10-fold odds of developing an OUD. Conclusions: Among construction workers, opioids initiated for musculoskeletal pain were strongly associated with incident long-term opioid use and OUD. Musculoskeletal pain from physically demanding work is likely one driver of the opioid epidemic in occupations like construction. Prevention of work injuries and alternative pain management are needed for workers at risk for musculoskeletal injuries.

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Section: Discussionsupporting

confidence: 91%

Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data

Buckner‐Petty¹,

Evanoff²,

Gage³

2020

American J Industrial Med

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“…We found that opioids were the most common analgesics used for pain management by patients with neck pain and that they were used for a relatively longer time compared to other common analgesics. Previous studies have shown that during recent decades excessive use of opioid analgesics has been and still is a common and serious problem in the USA [19][20][21]. Although many professional medical societies have made appeals to reduce the use of opioids, the level of opioid use in the USA remains fourfold higher than the current prescription rate in Europe and threefold higher than it was 1999 [19,22,23].…”

Section: Discussionmentioning

confidence: 99%

Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain

et al. 2020

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Introduction: Neck pain is a common condition that leads to serious pain, disability, and increased healthcare costs worldwide. Pharmacotherapy is one of the most common strategies to reduce neck pain in patients. The aim of this study was to analyze the real-world pattern of drugs prescribed for patients with neck pain in the USA. Methods: Data on individuals who reported current neck pain in the 2009-2010 US National Health and Nutrition Examination Survey (NHANES) and with a history of persistent pain for at least 6 weeks or 3 months were extracted from the NHANES database. Those included in the study were divided into three groups based on the duration of pain: the without neck pain group (Group A); subacute group (Group B) with a history of 6 weeks of neck pain; and the chronic neck pain group (Group C) with a history of 3 months of neck pain. The use and duration of medication Digital Features To view digital features for this article go to

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“…The context and scale of NSAID associated cardiovascular side effects in the population , their unintended impact on opioid use (Stokes, Berry, Hempstead, Lundberg, & Neogi, 2019) and the missed opportunity to prevent cancer are discussed elsewhere and together highlight the need for continued research in the area. However, the specific downstream mechanisms by which NSAIDs cause cardiovascular side effects are incompletely understood but it is clear that blocking COX-2 is the fulcrum and that incidental blockade of COX-1 by traditional NSAIDs does not mitigate the risk of cardiovascular side effects.…”

Section: Effects Of Nsaids In the Cardiovascular Systemmentioning

confidence: 99%

Cyclooxygenases and the cardiovascular system

Mitchell

Kirkby

Ahmetaj‐Shala

et al. 2021

Pharmacology & Therapeutics

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Cyclooxygenase (COX)-1 and COX-2 are centrally important enzymes within the cardiovascular system with a range of diverse, sometimes opposing, functions. Through the production of thromboxane, COX in platelets is a pro-thrombotic enzyme. By contrast, through the production of prostacyclin, COX in endothelial cells is antithrombotic and in the kidney regulates renal function and blood pressure. Drug inhibition of COX within the cardiovascular system is important for both therapeutic intervention with low dose aspirin and for the manifestation of side effects caused by nonsteroidal anti-inflammatory drugs. This review focuses on the role that COX enzymes and drugs that act on COX pathways have within the cardiovascular system and provides an in-depth resource covering COX biology and pharmacology. The review goes on to consider the role of COX in both discrete cardiovascular locations and in associated organs that contribute to cardiovascular health.We discuss the importance of, and strategies to manipulate, the thromboxane: prostacyclin balance.Finally within this review the authors discuss testable COX-2-hypotheses intended to stimulate debate and facilitate future research and therapeutic opportunities within the field.

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Trends in Prescription Analgesic Use Among Adults With Musculoskeletal Conditions in the United States, 1999-2016

Cited by 37 publications

References 42 publications

Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data

Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data

Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain

Cyclooxygenases and the cardiovascular system

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