• Jennifer Brennan Braden, Mark D Sullivan, G Thomas Ray, Kathleen Saunders, Joseph Merrill, Michael J Silverberg, Carolyn M Rutter, Constance Weisner, Caleb Banta-Green, Cynthia Campbell, and Michael Von Korff.
• Department of Psychiatry and Behavioral Sciences, Box 356560, University of Washington, Seattle, WA 98195-6560, USA. jkbrenn@u.washington.edu
• Gen Hosp Psychiatry. 2009 Nov 1; 31 (6): 564-70.

ObjectiveWe report trends in long-term opioid use among patients with a history of depression from two large health plans.MethodsUsing claims data, age- and gender-adjusted rates for long-term (>90 days) opioid use episodes were calculated for 1997-2005, comparing those with and without a depression diagnosis in the prior 2 years. Opioid use characteristics were calculated for those with a long-term episode in 2005.ResultsIncident and prevalent long-term opioid use rates were three times higher in those with a history of depression. Prevalent long-term use per 1000 in patients with a history of depression increased from 69.8 to 125.9 at Group Health and from 84.3 to 117.5 at Kaiser Permanente of Northern California between 1997 and 2005. Those with a history of depression were more likely to receive a higher average daily dose, greater days supply, and Schedule II opioids than nondepressed persons.ConclusionPersons with a history of depression are more likely to receive long-term opioid therapy for noncancer pain than those without a history of depression. Results suggest that long-term opioid therapy for noncancer pain is being prescribed to a different population in clinical practice than the clinical trial populations where opioid efficacy has been established.

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