Faculty Collaboration Database

Long-term opioid therapy trends in the VA: More intermittent than chronic. J Opioid Manag 2025;21(2):131-140

Date

05/06/2025

Pubmed ID

40326725

DOI

10.5055/jom.0896

Scopus ID

2-s2.0-105003715067 (requires institutional sign-in at Scopus site)

Abstract

OBJECTIVE: To observe patterns of opioid therapy among veterans with a focus on long-term opioid therapy (LTOT).

DESIGN: A retrospective study utilizing data from the Veterans Affairs Corporate Data Warehouse.

SUBJECTS: Veterans 18 years or older, who received at least one outpatient opioid prescription between June 1, 2008, and June 1, 2018, and had no cancer, palliative care, or hospice encounters during the study period.

MAIN MEASURES: For each patient, opioid prescriptions were combined into one contiguous prescription, as long as the gap (<7, <30, <90 days) between the end of supply and the receipt of the next fill met specified intervals. When gaps exceeded the threshold, a new prescription chain began. This was done to explore patterns of opioid fills.

RESULTS: There were 746,658 patients with a prescription gap <7 days who received 5,084,346 contiguous opioid scripts. For all gap lengths, 16-35 percent of contiguous scripts lasted at least 90 days, 3-14 percent lasted more than a year, and 1-8 percent lasted 2 years. While a relatively small proportion of contiguous scripts were long-lasting, a substantial proportion of patients received long-lasting opioid therapy.

CONCLUSIONS: Long-term, intermittent opioid therapy was common. However, the long-term, monthly, uninterrupted opioid prescriptions expected with typical LTOT was not. It is likely that LTOT in past research was more reflective of periodic use instead of continuous, monthly prescriptions, especially for multiyear studies.

Author List

Kay C, Sherman K, Sparapani R

Authors

Cynthia Kay MD Associate Professor in the Medicine department at Medical College of Wisconsin
Rodney Sparapani PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Analgesics, Opioid
Chronic Pain
Drug Prescriptions
Female
Humans
Male
Middle Aged
Practice Patterns, Physicians'
Retrospective Studies
Time Factors
United States
United States Department of Veterans Affairs
Veterans