• Cynthia Kay, Joanne Bernstein, Nicole Fergestrom, and Jeffrey L Jackson.
• Zablocki VA Medical Center.
• Clin J Pain. 2018 Dec 1; 34 (12): 1121-1125.

ObjectivesOverall opioid prescribing rates have decreased since 2012, but opioid-involved deaths have not. This study describes the regional and overall trends of opioid-related emergency department visits (EDVs) and hospitalizations of commercially insured patients on chronic opioids and those on concurrent opioids and benzodiazepines.MethodsSecondary data analysis from Truven Health MarketScan Commercial Claims and Encounters (MarketScan) database from 2009 to 2015 was used. Outcomes were geographic rates of opioid-related EDVs and hospitalizations and rates of concurrent benzodiazepine and opioid use.ResultsRates of opioid-related EDVs and hospitalizations for patients on chronic opioids have decreased since 2009. Two thirds of those with opioid-related EDVs and nearly 3-quarters of those with an opioid-related hospitalization were coprescribed benzodiazepines. The North Central region had the highest proportion of individuals on chronic opioid therapy (2.7%) in 2015. However, the South had not only the highest rates of opioid-related EDVs (23/100,000 in 2015) and opioid-related hospitalizations (39/100,000 in 2015) but also the largest percentage of individuals on concurrent opioids and benzodiazepines (41%).DiscussionRates of opioid-related EDVs and hospitalizations, as well as concurrent opioid and benzodiazepine use, vary geographically. More research is needed to examine factors that impact regional variation and what influences the concurrent use of opioids and benzodiazepines.

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