• Am J Prev Med · Dec 2024

    Decreasing Incident Opioid Use Disorder, Especially Adolescent and Young Adult.

    • Valerie S Harder, Nathaniel H Schafrick, Catherine E Peasley-Miklus, and Andrea C Villanti.
    • Department of Psychiatry, Center on Rural Addiction, University of Vermont Larner College of Medicine, Burlington, VT; Department of Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT. Electronic address: Valerie.Harder@med.uvm.edu.
    • Am J Prev Med. 2024 Dec 5.

    IntroductionOpioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder (OUD). OUD prevalence may have decreased in recent years, but there are few studies on trends of OUD incidence. The objective of this study was to examine OUD incidence rates to detect population changes overall and within demographic subgroups over time.MethodsIn 2023, a longitudinal analysis of incident OUD diagnoses was conducted after implementation of Vermont's July 2017 policy limiting opioid analgesic prescriptions for acute pain. Included were individuals 16+ years with medical claims in Vermont's all-payer claims database between July 1, 2017 and December 31, 2021. Multiple Poisson regression models assessed changes in OUD incidence rates per month overall, controlling for age, sex, rurality, and insurance type, and separately, testing age, rurality, and insurance as moderators.ResultsAmong 537,707 individuals, there was a 0.8% decrease per month in the OUD incidence rate (95% CI: 0.991, 0.993) from July 2017 through December 2021. Age moderated the association between OUD incidence and time, with the largest decrease per month (1.6%) among 16-29 year-olds (95% CI: 0.981, 0.986). There were smaller decreases in OUD incidence rate per month among 30-44 year-olds (0.6%), 45-59 year-olds (0.5%), and 60+ year-olds (0.6%).ConclusionsThis study found that the OUD incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) - December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.Copyright © 2024. Published by Elsevier Inc.

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