Bulk of opioid use in the U.S. concentrated among 10 percent of patients

A small proportion (10 percent) of opioid users account for the vast majority of opioid use in the United States. These findings suggest that efforts to reduce prescription opioid abuse should focus on the top users, rather than taking a population-based approach. The brief research report is published in Annals of Internal Medicine.

Deaths from prescription opioids have sharply increased in the United States. In response, the Centers for Disease Control and Prevention (CDC) recently issued recommendations for opioid prescribing for chronic pain. What's missing from these guidelines and other public health efforts to prevent opioid misuse is information about the distribution opioid use across the population.

Researchers at the Stanford University Medical Center studied pharmacy data for privately insured adults without cancer who were enrolled for at least one year between 2001 and 2013 and filled at least one prescription for an opioid during that time. The data showed that the top 10 percent of patients accounted for the most opioid use. Further research aimed at characterizing this population, analyzing the incidence of opioid-related adverse events, and identifying approaches to reduce its use could be most effective in reducing total population-level events.