Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population:...

Area of Science:

• Neuroscience
• Public Health
• Health Economics

Background:

• Post-traumatic pain is a common and debilitating complication following spinal cord injury (SCI).
• Long-term, high-dose opioid use is frequently prescribed for SCI-related pain, carrying a significant risk of dependence.
• There is a critical knowledge gap regarding the incidence of opioid dependence and its impact on healthcare utilization and costs in SCI patients.

Purpose of the Study:

• To investigate the association between spinal cord injury (SCI) and the development of post-injury opioid use and dependence.
• To evaluate the impact of opioid dependence on healthcare utilization patterns after SCI.

Main Methods:

• Analysis of healthcare utilization claims data from the MarketScan Database (2000-2019).
• Inclusion of 7187 adult patients with traumatic spinal cord injury (SCI).
• Generalized linear regression models were employed to analyze factors associated with opioid use, dependence, healthcare utilization, and associated costs.

Main Results:

• Individuals with SCI were more likely to initiate opioid use or transition to dependence post-injury (31% increase) compared to those who reduced use or became non-users (14% decrease).
• Pre-existing opioid dependence before SCI dramatically increased the odds of post-injury dependence (OR 34).
• Opioid-dependent individuals post-SCI exhibited significantly higher healthcare payments (2x) and utilization (1.2-6x) compared to non-users.

Conclusions:

• Opioid use and dependence are strongly linked to elevated healthcare utilization and costs in the SCI population.
• Individuals with a history of opioid use prior to SCI are at higher risk for continued use and increased healthcare consumption post-injury.
• Pre- and post-injury opioid use history is crucial for informing treatment decisions in all individuals with SCI.