Researchers at the University of Missouri School of Medicine have identified specific populations more prone to receiving high-dose opioid prescriptions, which increase the risk of opioid use disorder. Their findings provide critical insights for healthcare providers and public health officials aiming to curb opioid addiction.
Understanding the Risks of Opioid Use
Opioids such as hydrocodone and oxycodone are commonly prescribed to manage severe pain. However, even when taken as directed, these medications can lead to tolerance—requiring higher doses for the same pain relief—and physical dependence. These factors raise the risk of developing opioid use disorder, a serious and potentially life-threatening condition.
Dr. Mirna Becevic, the study’s lead author, explains, “The severity of pain, duration of opioid use, dosage, and coexisting medical conditions like neurological or mental health disorders all contribute to the likelihood of opioid misuse.”
Key Findings from Missouri Medicaid Data
The research team analyzed over 3 million Medicaid claims from Missouri between 2017 and 2021, covering more than 300,000 patient observations. They compared this data with 2018 U.S. Census figures and 2020 data on primary care shortages to pinpoint risk factors.
Age and Gender: Middle-aged adults up to 60 years old, particularly males, were more likely to be prescribed high opioid doses. Prescriptions dropped sharply after age 60, possibly due to concerns about adverse effects and drug interactions.
Geographic and Demographic Factors: Urban areas with higher veteran populations and more primary care providers showed increased rates of high-dose opioid prescriptions.
Prescribing Patterns: Younger adults received opioids more conservatively, reflecting growing awareness of the opioid epidemic.
Implications for Public Health and Clinical Practice
These findings underscore the urgent need for targeted public health strategies to reduce high-dose opioid prescriptions. Dr. Becevic emphasizes the importance of clinician education on evidence-based pain management and opioid use disorder treatment, citing programs like Show Me ECHO that support healthcare providers.
While current guidelines recommend avoiding high-dose opioid prescriptions, this practice remains common in certain regions. The study’s focus on Missouri means results may not fully apply nationwide due to varying demographics and healthcare access.
Moving Forward: Recommendations for Patients and Providers
For Patients: If you are prescribed opioids, discuss the lowest effective dose and duration with your healthcare provider. Be aware of the risks of tolerance and dependence.
For Providers: Consider patient age, medical history, and local risk factors when prescribing opioids. Utilize telehealth and evidence-based programs to improve pain management and reduce opioid misuse.
For Policymakers: Support initiatives that increase access to primary care and addiction treatment, especially in urban and veteran-populated areas.
About the Study and Researchers
The study, titled “Identifying high-dose opioid prescription risks using machine learning: A focus on sociodemographic characteristics,” was published in the Journal of Opioid Management. It involved experts from the University of Missouri’s School of Medicine, Institute for Data Science and Informatics, Missouri Telehealth Network, and other institutions.
Dr. Mirna Becevic, an assistant professor specializing in telemedicine, led the research team, which included data scientists, epidemiologists, and psychiatrists.
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