Patients with serious mental illness are significantly more likely than their peers to receive chronic opioid medications, even after adjusting for medical comorbidities and chronic pain diagnoses, according to data published in BMC Psychiatry. Given the increased risk for opioid-related problems among patients with psychiatric diagnoses, the investigators advised a more cautious approach to prescribing that integrates expertise from mental health clinicians.
Dr. Ashli Owen-Smith, assistant professor in the Department of Health Policy & Behavioral Sciences at Georgia State University School of Public Health, led study efforts to examine opioid prescribing trends among patients with psychiatric diagnoses based on electronic medical record data from the Mental Health Research Network, a series of research centers across 15 states. Patients with diagnoses of major depressive disorder (n=65,750), bipolar disorder (n=38,117), and schizophrenia or schizoaffective disorder (n=12,916) were matched by age, sex, and Medicare status with controls without a history of mental illness (n=129,644). The researchers extracted data on noncancer chronic pain diagnoses and prescription opioid dispensing for all participants and conducted multivariate analyses to calculate the odds of receiving a chronic pain diagnosis and of receiving opioids in patients vs controls.
Even after adjustments for chronic pain levels and medical comorbidities, patients with mental illnesses remained at high risk for chronic opioid use. Study limitations included the use of opioid dispensing, rather than actual medication use, which may have affected certain associations.
Learn more about the study.
Learn more about Dr. Ashli Owen-Smith.Tags: Friday Letter Submission, Publish on March 06