Skip to main content

Local Economy Affects Opioid Prescribing to Disabled on Medicare

Local Economy Affects Opioid Prescribing to Disabled on Medicare

A new study shows that prescribing of opioid pain medications for non-elderly Americans on disability is “significantly” related to county-level economic factors, such as unemployment and income levels.

According to the study, published in Medical Care, about half of Medicare beneficiaries under age 65 received an opioid prescription in 2014.

Researcher Chao Zhou, Ph.D., and colleagues at the Centers for Disease Control and Prevention found that opioid prescribing for disabled adults is higher outside of “large central metro” counties, even after accounting for local economic factors.

The researchers analyzed data on nearly 3.5 million adults younger than 65 who were medically disabled, without cancer, without end stage renal disease, not receiving hospice care, and receiving Medicare Part D (prescription drug) benefits for at least 12 months in 2014.

Most Medicare beneficiaries under age 65 are Social Security Disability Insurance (SSDI) recipients, the researchers noted.

The researchers analyzed measures of opioid prescribing by county, including demographic and geographic variations. They also looked at how local economic factors, such as household income, unemployment rate, and income inequality, affected opioid prescribing.

About half of the study population (49 percent) had at least one opioid prescription during 2014. More than one-fourth (28 percent) were long-term opioid users, with six or more prescriptions.

The proportions of opioid prescriptions were higher for women than men; for White and Native American beneficiaries compared to other racial/ethnic groups; and for patients between the ages of 55 and 64 compared to younger groups, the study found.

Analysis of county-level differences showed more than just an urban/rural divide, according to the researchers.

“Large central metro” counties (inner-city) had lower opioid prescribing than all other classifications, including “large fringe metro” (suburbs), “micropolitan” (small cities), and “noncore” (rural) areas, according to the study’s findings.

“Large central metro areas were different from the rest of categories,” the researchers wrote in the study. “Large fringe metro areas were similar to rural counties.”

Areas of more intensive opioid prescribing in the South, Southwest, and Midwest closely overlapped with “regions of economic hardship,” the study discovered.

Confirming those associations, opioid prescribing was higher in counties with lower median household income and higher unemployment, the researchers noted.

Income inequality was also a significant factor, although the relationship was the opposite of expected: Counties with higher income inequality had lower measures of opioid use.

“The metro/non-metro pattern of opioid prescribing was different from that of other health indicators, such as smoking, cerebrovascular disease (stroke), and mortality,” Zhou said.

The researchers say further studies are needed to identify the “distinctive mechanism” explaining the higher opioid prescribing outside of urban areas.

Research is also needed to clarify the negative association with income inequality, they add. The researchers suggest that low income inequality might be linked to other factors, such as economic conditions or differences in medical practice, that lead to higher opioid prescribing.

“The opioid epidemic is part of a larger challenge primarily faced by white rural working-class Americans,” Zhou said, adding the new findings add to previous evidence that disabled persons in the SSDI program are “a particularly vulnerable segment of this demographic.”

Zhou added that he believes investment in economically depressed areas might be a helpful part of comprehensive approaches to battling the opioid crisis.

Source: Wolters Kluwer Health



from Psych Central News http://ift.tt/2Cu0gAi
via IFTTT

Become a patron of The Carlisle Wellness Network. Show everyone that you think this service is worth at least a buck. Go to; http://ift.tt/2i70pBW and pledge one dollar per month and help improve the resources it takes to gather the articles you see here as well as create fresh content including interviews an podcasts. We only need one dollar per month from all of our patrons to give The Carlisle Wellness Network a bright furture in the health and wellness social media ecosystem.

Comments

Popular posts from this blog

Hair Pulling, Nail Biting, Skin Peeling and Biting

All my life I’ve bitten my nails. It’s caused me a lot of trouble, especially with my bipolar mother who has always thought screaming and shouting at me (and often a smack when I was younger) would make me stop.At around 7 I also started biting and peeling the skin on my fingers which has caused a lot of social and health issues for me from being to ashamed to join in with prayers at school, to getting my fingers getting a fungal infection causing long lasting damage to my fingers.Soon after I started to pull out the tiny hairs on my legs during school assembles and by 12 I began to pull my eyebrow hair out.How can I stop doing this to myself? I don’t even realise I’m doing it half the time (I started biting the skin around my fingers just writing this and caused it to bleed a little). I’m afraid to bring this up with my parents because of how they have reacted in the past and I’m far too embarrassed to ask anyone I would typically trust. It has severally impacted how I interact with …

Painful Memories Evoke More Intense Emotions in Those With Depression

People with major depressive disorder (MDD) experience more intense negative emotions while recalling painful memories compared to non-depressed people, according to a new study published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.And although those with MDD were able to turn down their negative emotions about as well as non-depressed people, they used different brain circuits to do so.The new findings pinpoint brain differences in MDD associated with the processing of autobiographical memories — one’s memories of personal events and knowledge of one’s life — that help us develop our sense of self and guide our interactions with the world around us.“This study provides new insights into the changes in brain function that are present in major depression,” said journal editor Cameron Carter, M.D. “It shows differences in how memory systems are engaged during emotion processing in depression and how people with the disorder must regulate these systems i…

New video by FDMX Fitness on YouTube

TRX Back and Shoulder workout
Here we are back with the TRX Suspension trainer for a back and shoulder workout! We will be wearing our polar h7 heart rate monitors, to keep track of our heart rate zones and calories burned. We will be doing the following exercises in this TRX workout video 1. TRX Shoulder press 2. TRX Low Rows 3. TRX W-Drills/ TRX L-Drills 4. TRX Mid Rows 5. TRX Shoulder press 6. TRX High Rows 7. TRX W-Drills/ TRX L-Drills 8. TRX Mid Rows Be sure to check out all of our TRX workout videos at http://ift.tt/2n62Kj3


View on YouTube

Become a patron of The Carlisle Wellness Network. Show everyone that you think this service is worth at least a buck. Go to; http://ift.tt/2i70pBW and pledge one dollar per month and help improve the resources it takes to gather the articles you see here as well as create fresh content including interviews an podcasts. We only need one dollar per month from all of our patrons to give The Carlisle Wellness Network a bright furture in the health an…