Short-Term and Long-Term Opioid Prescribing by Specialty, 2010 to 2024

Area of Science:

• Public Health
• Pain Management
• Health Services Research

Background:

• Opioid prescribing has declined nationally for over a decade.
• Understanding trends by prescriber specialty and for short-term vs. long-term use is limited.
• Indications, decision-making, and harm potential differ significantly between short-term and long-term opioid use.

Purpose of the Study:

• To analyze US opioid analgesic prescribing trends from 2010 to 2024.
• To differentiate trends by prescriber specialty.
• To separately examine short-term and long-term opioid use episodes.

Main Methods:

• Cross-sectional study utilizing administrative claims data.
• Included commercially insured and Medicare Advantage patients (aged ≥65 or <65 with disability).
• Analysis covered patients with ≥90 days of enrollment; statistical analysis performed May-September 2025.

Main Results:

• 110.3 million opioid fills by 15 million patients were analyzed (2010-2024).
• Decreases in prescribing were more pronounced for long-term (74.6%-81.3% reduction) than short-term use.
• Prescribing shifted from primary care to pain medicine specialists, particularly in Medicare Advantage with disability cohort.

Conclusions:

• US opioid prescribing decreased most for long-term use episodes between 2010-2024.
• Prescribing is increasingly concentrated among pain medicine specialists.
• Findings highlight the need for non-opioid pain treatments and raise concerns about chronic pain patient access to care.