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Opioid prescriptions among the World Trade Center Health Program population.

Ruiling Liu¹, Geoffrey M Calvert², Kristi R Anderson²

¹World Trade Center Health Program, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30329, USA. lmq2@cdc.gov.

BMC Health Services Research

|December 1, 2023

Summary

Opioid prescriptions within the World Trade Center Health Program (WTC HP) were low and mainly for cancer or end-of-life care. WTC HP initiatives may have improved opioid prescribing, but continued monitoring is essential.

Keywords:

Outpatient opioid prescription Prescription indicator Quality improvement World Trade Center Health Program

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Area of Science:

Public Health
Pain Management
Health Services Research

Background:

The World Trade Center Health Program (WTC HP) provides healthcare to 9/11 attack survivors.
Survivors may face heightened risks of opioid use due to trauma.
In 2018, the WTC HP implemented strategies to optimize opioid prescribing and enhance non-opioid pain management.

Purpose of the Study:

To characterize outpatient opioid prescriptions dispensed to WTC HP members.
To analyze trends in opioid prescribing from 2013 to 2021.
To assess the impact of WTC HP interventions on opioid prescribing patterns.

Main Methods:

Utilized administrative and claims data from the WTC HP (July 2011–September 2022).
Focused analysis on opioid prescriptions dispensed between 2013 and 2021.
Examined prescription characteristics, including indication, dosage, and concurrent use of other medications.

Main Results:

3.7% of 108,285 eligible WTC HP members received 22,938 opioid prescriptions (2013-2021).
Prescriptions were predominantly for cancer-related pain (62.1%) and hospice/end-of-life care (11.1%).
While opioid use for cancer/hospice initially rose, it decreased by 2021. Non-cancer pain opioid prescriptions also declined significantly.

Conclusions:

Outpatient opioid prescription prevalence within the WTC HP was low, primarily for cancer/hospice care.
WTC HP interventions appear to correlate with improved opioid prescribing outcomes.
Continuous surveillance of opioid prescribing practices within the WTC HP is recommended.