Distribution of Opioid Exposure and Covariates by Health Care Organization
| Variable | VHA (n = 70,997) | BSWH (n = 13,777) | HFHS (n = 22,981) |
|---|---|---|---|
| Age, mean (SD), y | 55.4 (13.0) | 44.6 (15.1) | 47.7 (14.4) |
| Sex, male, No. (%) | 66,697 (93.9) | 5,163 (37.5) | 9,167 (39.9) |
| Race, white, No. (%) | 53,790 (75.8) | 9,542 (69.3) | 10,696 (46.5) |
| Insurance | |||
| VHA only, No. (%) | 46,196 (65.1) | … | … |
| Medicare, No. (%) | … | 1,846 (13.4) | 170 (0.7) |
| Married, No. (%) | 39,076 (55.0) | … | … |
| Opioid use duration | |||
| 1 to 30 d, No. (%) | 55,306 (77.9) | 12,817 (93.0) | 20,487 (89.1) |
| 31 to 90 d, No. (%) | 8,640 (12.2) | 765 (5.6) | 1,685 (7.3) |
| >90 d, No. (%) | 7,051 (9.9) | 195 (1.4) | 809 (3.5) |
| Last MED dosea | |||
| 1 to 50 mg/d, No. (%) | 66,601 (93.8) | 12,893 (93.6) | 20,006 (87.1) |
| 51 to 100 mg/d, No. (%) | 3,613 (5.1) | 706 (5.1) | 2,628 (11.4) |
| >100 mg/d, No. (%) | 783 (1.1) | 178 (1.3) | 347 (1.5) |
| Psychiatric comorbidity | |||
| Posttraumatic stress disorder, No. (%) | 10,357 (14.6) | 35 (0.3) | 123 (0.5) |
| Other anxiety, No. (%)c | 8,383 (11.8) | 771 (5.6) | 2,057 (9.0) |
| Nicotine dependence/history of smoking, No. (%) | 30,175 (42.5) | 1,070 (7.8) | 5,274 (22.9) |
| Alcohol abuse/dependence, No. (%) | 14,313 (20.2) | 234 (1.7) | 1,010 (4.4) |
| Any illicit drug abuse/dependence, No. (%) | 8,727 (12.3) | 101 (0.7) | 625 (2.7) |
| Metabolic/cardiovascular comorbidityb | |||
| Diabetes type 2, No. (%) | 29,946 (42.2) | 2,732 (19.8) | 7,101 (30.9) |
| Hypertension, No. (%) | 58,616 (82.6) | 6,845 (49.7) | 15,857 (69.0) |
| Cardiovascular disease, No. (%) | 61,380 (86.5) | 8,161 (59.2) | 17,444 (75.9) |
| Cerebrovascular disease, No. (%) | 14,938 (21.0) | 1,370 (9.9) | 3,560 (15.5) |
| Obesity diagnosis, No. (%) | 27,621 (38.9) | 2,640 (19.2) | 6,522 (28.4) |
| Other comorbidityb | |||
| Low testosterone, No. (%) | 2,171 (3.1) | 219 (1.6) | 313 (1.4) |
| Sleep apnea, No. (%) | 7,563 (10.6) | 1,196 (8.7) | 1,583 (6.9) |
| Painful conditionb | |||
| Arthritis, No. (%) | 58,504 (82.4) | 8,539 (62.0) | 18,381 (80.0) |
| Back pain, No. (%) | 46,592 (65.6) | 7,323 (53.2) | 15,915 (69.3) |
| Headache, No. (%) | 14,389 (20.3) | 3,631 (26.4) | 8391 (36.5) |
| Musculoskeletal pain, No. (%) | 44,817 (63.1) | 9,149 (66.4) | 19,273 (83.9) |
| Neuropathic pain, No. (%) | 22,995 (32.4) | 2,391 (17.4) | 5,212 (22.7) |
| Maximum pain score, mean (SD) | 8.4 (2.2) | … | … |
| Health care utilization | |||
| ≤25th percentile, No. (%) | 6,937 (9.8) | 3,134 (22.8) | 4,379 (19.1) |
| 26 to 50th percentile, No. (%) | 19,928 (28.1) | 4,394 (31.9) | … |
| 51 to 75th percentile, No. (%) | 24,540 (34.6) | 2,758 (20.0) | 13,620 (59.3) |
| >75th percentile, No. (%) | 19,592 (27.6) | 3,491 (25.3) | 4,982 (21.7) |
BSWH = Baylor Scott & White Health; GAD = generalized anxiety disorder; HFHS = Henry Ford Health System; MED = morphine equivalent dose; VHA = Veterans Health Administration.
↵a Opioid MED at end of follow-up period defined by new-onset depression, end, or incident opioid prescription, or last available observation.
↵b Comorbidities occurring before new-onset depression.
↵c Other anxiety disorders include panic disorder, obsessive-compulsive disorder, social phobia, generalized anxiety disorder, anxiety not otherwise specified.
d Cardiovascular diseases include hyperlipidemia, ischemic heart disease, diseases of pulmonary circulation, other heart disease, hypertensive heart disease, myocardial infarction.