Trends in Opioid Use Disorder in the Veterans Health Administration, 2005-2022

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Opioid use disorder (OUD) presents significant personal and societal challenges.
• Understanding temporal trends in OUD prevalence is essential for effective service planning.

Purpose of the Study:

• To analyze the time trends in OUD prevalence from 2005 to 2022.
• To examine these trends across different age, sex, and racial/ethnic groups within the Veterans Health Administration (VHA) population.

Main Methods:

• A serial cross-sectional study utilizing national VHA electronic medical record data from 2005 to 2022.
• Inclusion criteria: adult patients (≥18 years) with a current OUD diagnosis receiving outpatient care.
• Analysis involved multivariable logistic regression adjusted for age, sex, and race/ethnicity to assess prevalence changes over time.

Main Results:

• The annual prevalence of OUD diagnoses in VHA patients nearly doubled from 0.60% in 2005 to 1.16% in 2017, then decreased to 0.97% in 2022.
• Similar trends of increase followed by decrease were observed in men, women, and most age groups (under 65) and non-Hispanic White patients.
• Notably, OUD diagnoses increased among patients aged 65+ and decreased among Hispanic/Latino and non-Hispanic Black patients from 2005 to 2022.

Conclusions:

• The prevalence of OUD diagnoses in the VHA population peaked in 2017 and subsequently declined.
• These trends were largely influenced by changes observed in non-Hispanic White patients and those younger than 65 years.
• Ongoing public health initiatives focusing on OUD recognition, treatment, and prevention are necessary.