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

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

Research output: Contribution to journalArticle

101 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
Publication statusPublished - 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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