While long-term use of opioid medications has declined since 2015, millions of Americans—particularly older adults—are still prescribed these drugs for 90 days or longer, according to a study issued today in JAMA.Why It’s Relevant
Long-term opioid therapy, defined as 90 days or longer, is typically prescribed for patients with chronic pain conditions, but it’s been linked to opioid misuse, overdose, and addiction. National opioid stewardship efforts, regulatory reforms, and changes to clinical guidelines have led to a drop in overall opioid prescribing, but the impact on long-term prescribing hasn’t been clear.
By the Numbers
- Researchers leveraged the IQVIA Longitudinal Prescription Database, which captures 92% of U.S. retail pharmacy fills, to assess national trends in long-term opioid therapy.
- The number of patients with an active long-term opioid prescription dropped 24% between 2015 and 2023—from 5.6 million patients to 4.2 million patients.
- Long-term opioid prescriptions dropped across all age groups except among individuals ages 65 and up—who saw a 71% increase between 2015 and 2023.
- In 2023, Medicare covered nearly half of active long-term opioid prescriptions.
What’s More
The proportion of patients who were co-prescribed contraindicated or potentially risky medications with long-term opioids increased slightly over time. While co-prescribing with benzodiazepines dropped from 44% in 2015 to 34% in 2023, co-prescribing increased with gabapentinoids (47% to 59%) and stimulants (6% to 7%).
The Other Side
The study’s limitations included its exclusion of prescriptions dispensed at Veterans Affairs pharmacies and lack of information on prescribing indications, patient comorbidities, and prescriber characteristics.
Takeaway Message
“Because older adults are at higher risk of adverse events from polypharmacy, the increased rates of co-prescribing, particularly with gabapentinoids, raise additional safety concerns,” the researchers wrote.
Related Information
Source
Thuy D. Nguyen, et al. U.S. trends in long-term opioid therapy. JAMA. Published April 8, 2026. doi: doi.org/10.1177/02698811261420018
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