The incidence of opioid use disorder among people with acute and chronic pain managed with prescription opioids in the United States: economic and societal burden
Year: 2026
Type: article
Study design: Observational Study
Abstract: This retrospective, longitudinal, observational study evaluated the incidence of opioid use disorder (OUD) among patients newly initiating opioids to manage acute and chronic pain in the United States. Additionally, healthcare resource utilization (HCRU) and associated costs were analyzed. Adult patients newly treated with prescription opioids were identified within the MarketScan administrative claims databases (2016-2018). Patients were classified as experiencing acute or chronic pain based on total prescription pain medication use within one year of the initial opioid prescription. Subgroups of patients with or without OUD were identified using diagnosis codes. The 1-, 2-, and 3-year incidence rates of OUD were 0.21%, 0.32%, and 0.43%, respectively, among acute pain patients and 1.11%, 1.52%, and 1.92% among chronic pain patients. Unadjusted all-cause HCRU were substantially higher among patients with OUD compared to those without OUD over the 12-month period following OUD diagnosis. The associated unadjusted total all-cause healthcare costs were 3.1-times and 2.0-times higher for those with OUD compared to those without OUD in the acute and chronic pain cohorts, respectively. The total all-cause healthcare costs for patients with OUD remained significantly higher, even after adjusting for baseline characteristics. When extrapolated nationally, estimated costs for patients managing acute or chronic pain and newly diagnosed with OUD were $3.3 billion (B) and $5.9B, respectively, totaling $9.2B. Pain medication use was identified using claims for filled prescriptions; patients’ actual medication usage and use of over-the-counter medications cannot be ascertained. OUD diagnosis was based on specific ICD-10-CM diagnosis codes, potentially underestimating the true incidence and economic impact. Newly diagnosed OUD following prescription opioid use for managing acute and chronic pain imposes a substantial economic burden within the first year following OUD diagnosis. Increased use of effective non-opioid analgesics may help reduce the incidence and economic burden of OUD. Opioid medications are often prescribed to help people manage pain, but they can sometimes lead to opioid use disorder (OUD), a condition where individuals become dependent on these drugs. This study looked at how often OUD occurs in people who start taking opioids for acute (short-term) or chronic (long-term) pain in the United States, as well as the healthcare costs associated with OUD. The study found that OUD is more common in people using opioids for chronic pain compared to those using them for acute pain. Over three years, about 0.43% of acute pain patients and 1.92% of chronic pain patients developed OUD. Based on descriptive analyses, patients with OUD used more healthcare services and had significantly higher medical costs than those without OUD. For example, healthcare costs were about three times higher for acute pain patients with OUD and twice as high for chronic pain patients with OUD. Even after accounting for differences in patient characteristics between cohorts, patients with OUD incurred significantly greater healthcare costs than patients without OUD. When these findings were extrapolated to the entire US population, the total healthcare costs for patients with newly diagnosed OUD were estimated to be $9.2 billion. This study highlights the significant financial and health impact of OUD. Using effective non-opioid pain treatments may help reduce the risk of OUD and associated healthcare costs.
Source: Figshare
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7160302192