Risk of Adverse Health Outcomes with Increasing Duration and Regularity of Opioid Therapy

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Figure 1.
Opioid analgesic users by type and duration of use, 2008 to 2010, Truven Health MarketScan.
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Figure 2.
Selected outcomes among opioid analgesic user groups by time period, 2008 to 2010, Truven Health MarketScan. A: Percentage of users prescribed a benzodiazepine. B: Drug abuse rate per 1000 people. C: Drug overdose rate per 1000 people. D: Opioid analgesic overdose rate per 1000 people. Numbers 1–6 refer to user groups. Circles indicate time periods without opioid use. J-J, January through June; J-D, July through December.
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Figure 3.
Selected outcomes among daily opioid analgesic user groups by time period, 2008 to 2010, Truven Health MarketScan. A: Percentage of users prescribed a benzodiazepine. B: Drug abuse rate per 1000 people. C: Drug overdose rate per 1000 people. D: Opioid analgesic overdose rate per 1000 people. Numbers 1–6 refer to user groups. Circles indicate time periods without opioid use. J-J, January through June; J-D, July through December.
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Figure 4.
Distributions of health outcomes by type of use of opioid analgesics, January through June 2008, Truven Health MarketScan.

Table 1. Characteristics of Opioid Analgesic Use by Duration of Use for All Users and Daily Users, 2008–2010

Characteristics by User Group	Time Period of Opioid Use												Mean Use
	Jan-June 2008		July-Dec 2008		Jan-June 2009		July-Dec 2009		Jan-June 2010		July-Dec 2010
	Mean	Median	Mean	Median	Mean	Median	Mean	Median	Mean	Median	Mean	Median
All users^*
Days of use
Group 1	8	5											8
Group 2	16	6	14	6									15
Group 3	26	10	28	10	21	9							25
Group 4	40	16	43	20	42	20	33	15					40
Group 5	50	25	55	30	55	30	53	30	37	20			50
Group 6	98	92	107	114	110	120	115	128	115	130	116	132	110
Daily dosage (MME)
Group 1	52	37.5											52
Group 2	50	37.5	50	38									50
Group 3	50	36	50	36	48	37							49
Group 4	50	35	50	35	50	35	50	35					50
Group 5	53	35	52	35	52	34	52	34	50	33			52
Group 6	72	38	74	39	75	40	77	40	79	40	80	40	76
Daily users^{^†}
Days of use
Group 1	134	137											134
Group 2	138	145	76	60									107
Group 3	142	150	116	120	66	57							108
Group 4	147	153	130	146	112	120	76	60					116
Group 5	148	160	137	150	125	144	115	127	70	60			119
Group 6	157	167	154	168	151	166	154	169	150	166	150	168	153
Daily dosage (MME)
Group 1	54	34											54
Group 2	70	39	66	38									68
Group 3	69	37	69	37	61	36							66
Group 4	74	40	75	40	75	40	71	39					74
Group 5	83	41	80	41	83	40	81	40	72	38			80
Group 6	101	46	105	47	108	48	111	50	113	51	114	51	109

Data from Truven Health MarketScan.
↵* Among all users, group 1 included 474,211 patients; group 2, 104,602 patients; group 3, 37,062 patients; group 4, 19,481 patients; group 5, 12,302 patients; and group 6, 141,799 patients. Total number of patients was 789,457.
↵† Among daily users, group 1 included 1,026 patients; group 2, 2,255 patients; group 3, 1,988 patients; group 4, 2,033 patients; group 5, 1,885 patients; and group 6, 62,066 patients. Total number of patients was 71,253.
MME, morphine milligram equivalent.