Poster Abstracts

The Societal Impact of Prescription Opioid Use and Opioid Use Disorder and in the United States: A Current Perspective (2016–2023)

POSTER ABSTRACT

Author(s)

AS

Andrew J. Schoenfeld, M.D.

Professor of Orthopedic Surgery
Brigham and Women’s Hospital
Boston, Massachusetts
DB

Danielle Badgley, M.S.

Senior Consultant
Maple Health Group, LLC
New York, New York
KB

Karolina Badora, Ph.D

Senior Medical Writer
Maple Health Group, LLC
New York, New York
KD

Kim T. Dangova, MSc

Associate Consultant
Maple Health Group, LLC
New York, New York
SK

Scott J. Keating, M.S.

Health Economics & Outcomes Research Associate Director
Vertex Pharmaceuticals Incorporated
Boston, Massachusetts
KP

Konrad Pisarczyk, MPH

Consultant
Maple Health Group, LLC
New York, New York
AM

Ann M. Menzie, M.S.

Senior Director, Health Economics & Outcomes Research
Vertex Pharmaceuticals Incorporated
Boston, Massachusetts

Abstract Title: The Societal Impact of Prescription Opioid Use and Opioid Use Disorder and in the United States: A Current Perspective (2016–2023)

Background: The United States (US) continues to face a decades-long public health challenge related to prescription opioid use, opioid use disorder (OUD), and the associated societal consequences thereof. In 2016, the Centers for Disease Control and Prevention (CDC) issued guidance aiming to limit opioid prescribing practices and reduce the risk of OUD- and overdose-related deaths.¹ This led to a shift in opioid prescribing practices as many states implemented policies aligned with CDC recommendations.² Despite these efforts, opioids remain widely prescribed, contributing to the high prevalence of OUD.³ OUD resulting from prescription opioids has substantial societal consequences, including increased healthcare expenditures, lost productivity, absenteeism, and mortality.^4,5 Since the CDC guidelines were issued, there have also been serious disruptions to the healthcare system driven by the COVID-19 pandemic. Understanding how these factors have influenced opioid prescribing and the prevalence of OUD are crucial for combatting the ongoing opioid crisis.

Purpose/Objectives: We conducted a systematic literature review (SLR) to exhaustively assess trends in prescription opioid use, incidence or prevalence of OUD, and the associated societal impact. First, we aimed to characterize temporal fluctuations in prescription opioid use over the last 8 years, illustrating trends and patterns observed in the literature. Second, we sought to describe the current epidemiology of OUD resulting from prescription opioid use. Last, we intended to identify and characterize the societal burden associated with OUD resulting from prescription opioid use. This included examining the economic burden through healthcare expenditures, lost productivity, absenteeism, and mortality. By quantifying these costs, we intended that this review would contribute to a comprehensive assessment of the overall impact of OUD on individuals, communities, and American society resulting from prescription opioid use.

Method: An SLR was conducted using the MEDLINE and Embase databases to identify studies published in the US between 01/01/2016 and 05/04/2023. Study selection and data extraction followed the guidance published by the University of York, Centre for Reviews and Dissemination (CRD) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles identified in the search were screened by title and abstract, and included articles were subsequently reviewed in full. During both title/abstract and full-text screening, articles were reviewed independently by two reviewers, with disagreement resolved via consensus. If a consensus was not reached, unresolved conflicts were adjudicated by a third senior reviewer. This review is registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023425703).

Results: 14,268 articles were identified for screening. To date, 7,811 abstracts have been reviewed and 702 have been included for full text review. These numbers will increase as the screening continues. The review is currently ongoing and will provide information on the trends in opioid prescription patterns, prevalence of OUD arising from prescription opioid use, and the associated economic impact in terms of healthcare expenditures, lost productivity, absenteeism, and mortality in the US.

Conclusions: This review will characterize current estimates of prescription opioid use, OUD, and associated societal costs, gleaned from peer-reviewed research published between 2016 and 2023. Preliminary findings from the review suggest substantial societal impacts resulting from prescription opioid use and OUD despite the ongoing shift in opioid prescribing practices. Furthermore, these preliminary findings highlight the urgent need for novel therapeutics and comprehensive strategies to provide a non-opioid option for pain management and address the underlying factors contributing to the development of OUD.

References: 1. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49
2. Bohnert ASB, Guy GP, Losby JL. Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention's 2016 opioid guideline. Ann Intern Med. 2018;169(6):367-375
3. Williams E, Saunders H. A look at changes in opioid prescribing patterns in Medicaid from 2016 to 2019. Kaiser Family Foundation. 2023 Feb.
4. Luo F, Li M, Florence C. State-level economic costs of opioid use disorder and fatal opioid overdose – United States, 2017. MMWR Recomm Rep 2021;70(No. 15):541-546
5. Henke RM, Ellsworth D, Wier L, Snowdon J. Opioid use disorder and employee work presenteeism, absences, and health care costs. JOEM 2020;62(5):344-349