Decreasing Incident Opioid Use Disorder, Especially Adolescent and Young Adult

Opioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder. Opioid use disorder prevalence may have decreased in recent years, but there are few studies on trends of opioid use disorder incidence. The objective of this study was to examine opioid use disorder incidence rates to detect population changes overall and within demographic subgroups over time.

In 2023, a longitudinal analysis of incident opioid use disorder diagnoses was conducted after implementation of Vermont's July 2017 policy limiting opioid analgesic prescriptions for acute pain. Included were individuals ≥16 years with medical claims in Vermont's all-payer claims database between July 1, 2017, and December 31, 2021. Multiple Poisson regression models assessed changes in opioid use disorder incidence rates per month overall, controlling for age, sex, rurality, and insurance type, and separately, testing age, rurality, and insurance as moderators.

Among 537,707 individuals, there was a 0.8% decrease per month in the opioid use disorder incidence rate (95% CI=0.991, 0.993) from July 2017 through December 2021. Age moderated the association between opioid use disorder incidence and time, with the largest decrease per month (1.6%) among those aged 16-29 years (95% CI=0.981, 0.986). There were smaller decreases in opioid use disorder incidence rate per month among those aged 30-44 years (0.6%), 45-59 years (0.5%), and ≥60+ years (0.6%).

This study found that the opioid use disorder incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) and December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.