Odds of Reducing Opioid Usage to Zero Among Oregon Medicaid Patients with Back or Neck Pain on Long-Term Opioid Therapy
| Unadjusted or (95% CI) | Adjusted* OR (95% CI) | |
|---|---|---|
| Sex | ||
| Male | Ref | Ref |
| Female | 0.98 (0.81–1.18) | 0.93 (0.76–1.14) |
| Age, years | ||
| 19 to 34 | Ref | Ref |
| 35 to 49 | 0.84 (0.59–1.20) | 0.91 (0.63–1.30) |
| 50 to 64 | 0.56 (0.40–0.78) | 0.62 (0.43–0.88) |
| Race/ethnicity | ||
| Hispanic, Black, Indigenous, other patients of color, and unknownrace/ethnicity | Ref | Ref |
| Non-Hispanic White | 1.55 (1.17–2.04) | 1.61 (1.21–2.15) |
| Eligible pain diagnoses | ||
| Back pain | Ref | Ref |
| Neck pain | 0.74 (0.55–0.99) | 0.73 (0.55–0.99) |
| Both | 1.02 (0.81–1.28) | 1.05 (0.83–1.34) |
| Baseline average daily MME | ||
| <20 MME | Ref | Ref |
| 20 - <50 MME | 0.81 (0.65–1.01) | 0.81 (0.65–1.01) |
| 50 - <90 | 0.84 (0.63–1.12) | 0.79 (0.59–1.06) |
| ≥90 | 0.81 (0.60–1.10) | 0.75 (0.55–1.04) |
| Number of visits in the prior year | ||
| <6 | Ref | Ref |
| 6 to 9 | 0.98 (0.76–1.27) | 1.02 (0.78–1.32) |
| 10 to 12 | 1.05 (0.78–1.41) | 1.09 (0.81–1.48) |
| >12 | 1.14 (0.89–1.48) | 1.20 (0.92–1.57) |
| Charlson Comorbidity Index† | ||
| 0 | Ref | Ref |
| 1 to 2 | 0.63 (0.48–0.82) | 0.64 (0.49–0.85) |
| ≥3 | 0.60 (0.46–0.80) | 0.68 (0.50–0.93) |
| N pain clusters (of 8)† ‡ | ||
| 0 | Ref | Ref |
| 1 | 0.84 (0.65–1.10) | 0.87 (0.66–1.14) |
| ≥2 | 0.82 (0.63–1.05) | 0.84 (0.64–1.10) |
| Alcohol abuse/dependence† | 1.01 (0.74–1.40) | 1.03 (0.74–1.44) |
| Opioid abuse/dependence† | 1.64 (1.03–2.59) | 1.70 (1.05–2.71) |
| Other drug abuse/dependence† | 1.08 (0.82–1.43) | 0.98 (0.73–1.32) |
| Mood disorder† § | 1.08 (0.90–1.31) | 1.16 (0.94–1.43) |
Abbreviations: OR, odds ratio; MME, morphine milligram equivalence, CI, confidence interval Bold, P < .05.
↵* Model adjusted for all variables in this table.
↵† Conditions based on active problem list entries at baseline.
↵‡ Pain conditions assessed: (1) limb/extremity pain, joint pain, and arthritic disorders; (2) neuropathic pain conditions; (3) headache; (4) abdominal and bowel pain; (5) urogenital, pelvic, and menstrual pain; (6) musculoskeletal chest pain; (7) systemic disorders or diseases causing pain; (8) orofacial, ear, and temporomandibular disorder pain. See Appendix Table 1 for definitions.
↵§ Includes depression and anxiety disorders. See Appendix Table 1 for definitions.