Online Program

Gender differences in opioid prescriptions among americans with Medicaid, 2010

Monday, November 4, 2013

Karin A. Mack, PhD, Division of Analysis, Research and Practice Integration, CDC's Injury Center, Atlanta, GA
Christopher Jones, PharmD, Prescription Drug Overdose Team - HSTSB DUIP NCIPC CDC, CDC's Injury Center, atlanta, GA
Leonard Paulozzi, MD, MPH, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Kun Zhang, PhD, Prescription Drug Overdose Team HSTSB DUIP NCIPC CDC, Centers for Disease Control and Prevention, Atlanta, GA
Background: The purpose of this study was to examine gender differences in opioid use among Medicaid recipients, a group at high risk of opioid overdose. Methods: Using claims in the 2010 MarketScan┬« Multi-State Medicaid databases, we identified 359,368 enrollees with at least one opioid prescription among continuously enrolled, Medicaid recipients aged 18-64 years in 12 states. Indicators included number of prescriptions, overlapping prescriptions, and high daily doses of opioids (≥100 morphine milligram equivalents per day). Results: Medicaid recipients in the sample received over 2,000,000 opioid prescriptions in 2010. The mean number of opioid prescriptions was higher for males (7.1) than females (6.0). A significantly higher percentage of women, however, received potentially risky prescription combinations (opioid and benzodiazepine; 30.6%; opioid and muscle relaxant; 33.7%; opioid, benzodiazepine and muscle relaxant 15.7%) than men (28.2%; 32.5%; 12.7% respectively). A significantly higher percentage of women had a single incident during the year of receiving a high daily dose of an opioid (10%) than men (7.3%), but men were more likely to have two or more incidents (10%) compared to women (7.4%). Conclusions: Despite the fact that men are more likely to use opioids nonmedically and to die from drug overdoses involving opioids, some measures of potential risk were higher in women than men, thus identifying gender-specific foci for intervention. The use of integrated claims data, similar to our analyses, might reduce overdose, by detecting prescribing and use behaviors that contribute to risk and thus leading to improved quality of care.

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Discuss gender differences in potentially risky prescription use or prescribing

Keyword(s): Prescription Drug Use Patterns, Gender

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Acting Team for the Prescription Drug Overdose Team @ CDC's Injury Center. My scientific interests include tracking the supply of opioids in the US.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.