{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:35:59Z","timestamp":1790649359684,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,13]],"date-time":"2017-08-13T00:00:00Z","timestamp":1502582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Opioid prescribing recently has come under intense scrutiny. However, longitudinal patterns of prescription opioid receipt in a population\u2010based cohort of patients with chronic pain, such as those with rheumatoid arthritis (RA), have not been well characterized. The aim of this study was to examine both trends over time and variability in individual physician prescribing of short\u2010term and long\u2010term use of opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified a cohort of RA patients based on 2006\u20132014 Medicare data and evaluated longitudinal time trends in \u201cregular\u201d use of opioids. A separate analysis conducted in 2014 assessed rheumatologist\u2010specific variability in regular use of opioid prescriptions in patients with RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 97,859 RA patients meeting the eligibility criteria. The mean age of the patients was 67 years, 80% were female, 82% were white, and 12% were African American. The most commonly used opioids were those that combined acetaminophen with hydrocodone or propoxyphene. Regular opioid prescribing increased slowly but peaked in 2010 before propoxyphene was withdrawn from the market. Following the withdrawal of propoxyphene, receipt of hydrocodone and tramadol increased commensurately, and overall opioid use declined only slightly. Factors associated with regular use of opioids included younger age, female sex, African American race, back pain, fibromyalgia, anxiety, and depression. Variability between US rheumatologists (n\u2009=\u20094,024) in prescribing the regular use of opioids for their RA patients was high; in the average rheumatologist's practice, 40% of RA patients used prescription opioids regularly. In almost half of the patients, at least some opioid prescriptions were written by a rheumatologist, and 14% received opioids that were co\u2010prescribed concurrently by more than 1 physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the US, opioid use in older patients with RA peaked in 2010 and is now declining slightly. Withdrawal of propoxyphene from the US market in 2010 had minimal effect on overall opioid use, because use of propoxyphene was replaced by increased use of other opioids.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40152","type":"journal-article","created":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T01:02:40Z","timestamp":1498006960000},"page":"1733-1740","source":"Crossref","is-referenced-by-count":70,"title":["Changing Trends in Opioid Use Among Patients With Rheumatoid Arthritis in the United States"],"prefix":"10.1002","volume":"69","author":[{"given":"Jeffrey R.","family":"Curtis","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglong","family":"Xie","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G.","family":"Saag","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lang","family":"Chen","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Beukelman","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Mannion","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifeng","family":"Yun","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kertesz","sequence":"additional","affiliation":[{"name":"Birmingham VA Medical Center and University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,13]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1487","article-title":"Vital signs: overdoses of prescription opioid pain relievers: United States, 1999\u20132008","volume":"60","author":"Paulozzi L","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_6_3_1","unstructured":"HeddenSL KennetJ LipariR MedleyG TiceP for the Substance Abuse and Mental Health Services Administration. 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