Full Breakdown
Trends in Long-Term Opioid Therapy in the United States
4/10/2026, 1:27:44 AM
Overview of Long-Term Opioid Therapy Trends
A recent study published in JAMA, led by researchers from the University of Michigan, reveals significant trends in long-term opioid therapy in the United States from 2015 to 2023. The analysis indicates that while long-term opioid prescribing has decreased, approximately 4.2 million patients were still engaged in long-term opioid therapy in 2023. This represents a 24.3% decline from about 5.6 million patients in 2015, highlighting both progress and ongoing challenges in managing chronic pain with opioids.
Key Findings on Patient Demographics and Prescribing Patterns
The study utilized IQVIA’s Longitudinal Prescription Database, which captures 92% of U.S. retail pharmacy prescriptions, to define long-term opioid therapy as opioid dispensing lasting 90 days or more. The average age of patients receiving long-term opioid therapy increased from 52.5 years in 2015 to 60.5 years in 2023, with Medicare coverage rising from 38.8% to 48.7%, indicating a shift towards an older patient demographic. Additionally, the average daily dose of opioids, measured in morphine milligram equivalents, decreased from 47.9 to 38.6, suggesting a trend towards more cautious prescribing practices.
Changes in Co-Prescribing Patterns
The study also examined co-prescribing trends, revealing a decline in the co-prescription of opioids with benzodiazepines, which decreased from 43.8% to 33.5%. Conversely, co-prescribing with gabapentinoids increased from 47% to 58.7%, while stimulant co-prescribing rose slightly from 5.9% to 6.7%. These shifts reflect evolving clinical strategies in managing complex pain conditions and highlight the need for careful monitoring to mitigate risks associated with opioid use.
Implications for Pain Management
Thuy Nguyen, the study's lead author, emphasized the importance of developing evidence-based guidelines for chronic pain management, noting that nearly one in nine patients receiving prescription opioids were chronic users in 2023. Pooja Lagisetty, the senior author, pointed out the necessity for innovative treatment models that prioritize safety and efficacy in pain management, especially given the ongoing reliance on long-term opioid therapy.
Limitations of the Study
Despite its valuable insights, the study acknowledges limitations, including its reliance on prescription dispensing data, which does not account for prescribing indications, patient comorbidities, or adherence to prescribed medications. This lack of comprehensive data may affect the understanding of patient behaviors and outcomes related to opioid therapy.
Conclusion: The Need for Continued Vigilance
The findings underscore the persistent prevalence of long-term opioid use in the U.S., necessitating ongoing attention to safer prescribing practices and access to effective pain management options. As the landscape of opioid therapy continues to evolve, a focus on integrated, evidence-based approaches remains essential to safeguard patient health and address the complexities of chronic pain management.
Verbatim Quotes
“Nearly 1 in 9 patients receiving prescription opioids were still chronic opioid users in 2023, highlighting the importance of developing and implementing evidence-based guidelines for chronic pain management,” — Thuy Nguyen, Assistant Professor, Health Management and Policy, University of Michigan
“Why it matters and what the study could not measure Pooja Lagisetty, the paper’s senior author and associate professor of Internal Medicine at the University of Michigan Medical School, says the data highlights the pressing need to develop improved treatment models for pain.” — Pooja Lagisetty, Associate Professor, Internal Medicine, University of Michigan Medical School
