Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV

William C. Becker, Kirsha Gordon, E. Jennifer Edelman, Robert D. Kerns, Stephen Crystal, James D. Dziura, Lynn E. Fiellin, Adam J. Gordon, Joseph L. Goulet, Amy C. Justice, David A. Fiellin

Publication Date: 03/01/2016

Harms of opioid analgesics, especially high-dose therapy among individuals with comorbidities and older age, are increasingly recognized. However, trends in opioid receipt among HIV-infected patients are not well characterized. We examined trends, from 1999 to 2010, in any and high-dose (≥120 mg/day) opioid receipt among patients with and without HIV, by age strata, controlling for demographic and clinical correlates. Of 127,216 patients, 64 % received at least one opioid prescription. Opioid receipt increased substantially among HIV-infected and uninfected patients over the study; high-dose therapy was more prevalent among HIV-infected patients. Trends in high-dose receipt stratified by three age groups revealed an increasing trend in each age strata, higher among HIV-infected patients. Correlates of any opioid receipt included HIV, PTSD and major depression. Correlates of high-dose receipt included HIV, PTSD, major depression and drug use disorders. These findings suggest a need for appropriate balance of risks and benefits, especially as these populations age.