Opioids for back pain patients: Primary care prescribing patterns and use of services

Richard A. Deyo, David H.M. Smith, Eric S. Johnson, Marilee Donovan, Carrie J. Tillotson, Xiuhai Yang, Amanda F. Petrik, Steven K. Dobscha

Research output: Contribution to journalArticlepeer-review

140 Scopus citations


Background: Opioid prescribing for noncancer pain has increased dramatically. We examined whether the prevalence of unhealthy lifestyles, psychologic distress, health care utilization, and co-prescribing of sedative-hypnotics increased with increasing duration of prescription opioid use. Methods: We analyzed electronic data for 6 months before and after an index visit for back pain in a managed care plan. Use of opioids was characterized as "none," "acute" (≤90 days), "episodic," or "long term." Associations with lifestyle factors, psychologic distress, and utilization were adjusted for demographics and comorbidity. Results: There were 26,014 eligible patients. Of these, 61% received a course of opioids, and 19% were long-term users. Psychologic distress, unhealthy lifestyles, and utilization were associated incrementally with duration of opioid prescription, not just with chronic use. Among long-term opioid users, 59% received only short-acting drugs; 39% received both long- and short-acting drugs; and 44% received a sedative-hypnotic. Of those with any opioid use, 36% had an emergency visit. Conclusions: Prescription of opioids was common among patients with back pain. The prevalence of psychologic distress, unhealthy lifestyles, and health care utilization increased incrementally with duration of use. Coprescribing sedative-hypnotics was common. These data may help in predicting long-term opioid use and improving the safety of opioid prescribing.

Original languageEnglish (US)
Pages (from-to)717-727
Number of pages11
JournalJournal of the American Board of Family Medicine
Issue number6
StatePublished - Nov 2011


  • Analgesics
  • Back pain
  • Pain control
  • Quality of health care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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