Analgesic methadone prescribing in community health centers among patients with chronic pain

Steffani R. Bailey; Jean P. O’Malley; Daniel M. Hartung; Nathalie Huguet; Miguel Marino; John Muench

doi:10.5055/jom.0811

Analgesic methadone prescribing in community health centers among patients with chronic pain

Steffani R. Bailey, Jean P. O’Malley, Daniel M. Hartung, Nathalie Huguet, Miguel Marino, John Muench

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain. Design: Observational; two cross-sectional periods. Setting: Oregon and California CHCs. Patients: Chronic pain patients with ≥1 visit in 2012-2013 or 2017-2018 (N = 158,239). Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with ≥1 methadone prescription. Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving ≥1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs ≥65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White). Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.

Original language	English (US)
Pages (from-to)	369-375
Number of pages	7
Journal	Journal of opioid management
Volume	19
Issue number	5
DOIs	https://doi.org/10.5055/jom.0811
State	Published - 2023

Keywords

chronic pain
community health centers
methadone
primary care

ASJC Scopus subject areas

Pharmacology (medical)
Anesthesiology and Pain Medicine

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10.5055/jom.0811

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title = "Analgesic methadone prescribing in community health centers among patients with chronic pain",

abstract = "Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain. Design: Observational; two cross-sectional periods. Setting: Oregon and California CHCs. Patients: Chronic pain patients with ≥1 visit in 2012-2013 or 2017-2018 (N = 158,239). Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with ≥1 methadone prescription. Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving ≥1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs ≥65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White). Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.",

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year = "2023",

doi = "10.5055/jom.0811",

language = "English (US)",

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AU - Hartung, Daniel M.

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AU - Marino, Miguel

AU - Muench, John

PY - 2023

Y1 - 2023

N2 - Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain. Design: Observational; two cross-sectional periods. Setting: Oregon and California CHCs. Patients: Chronic pain patients with ≥1 visit in 2012-2013 or 2017-2018 (N = 158,239). Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with ≥1 methadone prescription. Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving ≥1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs ≥65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White). Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.

AB - Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain. Design: Observational; two cross-sectional periods. Setting: Oregon and California CHCs. Patients: Chronic pain patients with ≥1 visit in 2012-2013 or 2017-2018 (N = 158,239). Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with ≥1 methadone prescription. Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving ≥1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs ≥65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White). Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.

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Analgesic methadone prescribing in community health centers among patients with chronic pain

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