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Trends in Prescriptions for Non-opioid Pain Medications Among U.S. Adults With Moderate or Severe Pain, 2014-2018.

Gorfinkel LR, Hasin D, Saxon AJ, Wall M, Martins SS, Cerdá M, Keyes K, Fink DS, Keyhani S, Maynard CC, Olfson M. Trends in Prescriptions for Non-opioid Pain Medications Among U.S. Adults With Moderate or Severe Pain, 2014-2018. The journal of pain. 2022 Jul 1; 23(7):1187-1195.

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As opioid prescribing has declined, it is unclear how the landscape of prescription pain treatment across the U.S. has changed. We used nationally-representative data from the Medical Expenditure Health Survey, 2014 to 2018 to examine trends in prescriptions for opioid and non-opioid pain medications, including acetaminophen, non-steroidal anti-inflammatory drugs, gabapentinoids, and antidepressants among U.S. adults with self-reported pain. Overall, from 2014 to 2018, the percentage of participants receiving a prescription for opioids declined, (38.8% vs 32.8%), remained stable for non-steroidal anti-inflammatory drugs (26.8% vs 27.7%), and increased for acetaminophen (1.6% vs 2.3%), antidepressants (9.6% vs 12.0%) and gabapentinoids (13.2% vs 19.0%). In this period, the adjusted odds of receiving an opioid prescription decreased (aOR  =  .93, 95% CI  =  .90-.96), while the adjusted odds of receiving antidepressant, gabapentinoid and acetaminophen prescriptions increased (antidepressants: aOR  =  1.08, 95% CI  =  1.03-1.13 gabapentinoids: aOR  =  1.11, 95% CI  =  1.06-1.17; acetaminophen: aOR  =  1.10, 95% CI: 1.02-1.20). Secondary analyses stratifiying within the 2014 to 2016 and 2016 to 2018 periods revealed particular increases in prescriptions for gabapentinoids (aOR  =  1.13, 95% CI  =  1.05-1.21) and antidepressants (aOR  =  1.23, 95% CI  =  1.12-1.35) since 2016. PERSPECTIVE: These data demonstrate that physicians are increasingly turning to CDC-recommended non-opioid medications for pain management, particularly antidepressants and gabapentinoids. However, evidence for these medications' efficacy in treating numerous common pain conditions, including low back pain, remains limited.

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