Studies Examine Association Between Opioid Prescriptions and Obesity

April 2, 2020

Obesity may contribute to incident long-term prescription opioid use due to underlying pain conditions.

Two new studies suggest an association between opioid prescriptions and obesity in the United States.

In the first study, which was published in the American Journal of Preventive Medicine, it was suggested that obesity contributed significantly to incident long-term prescription opioid use.

The researchers analyzed data from 89,629 adults aged 30 to 84 years of age who were prescription opioid-naïve for approximately 9 months. Among opioid-naïve adults, obesity was strongly associated with incident long-term prescription opioid use, according to the study. This association increased at progressively higher body mass index (BMI) values, with 24% increased odds (95% CI=106%, 224%) in adults who are overweight and 158% increased odds (95% CI=106%) among adults with class 3 obesity. Additionally, these associations grew with higher-dosage opioids. At the population level, 27% of incident long-term prescription opioid use (95% CI=19.0%, 34.8%) was attributable to adults having a BMI above normal weight, according to the study.

Joint pain, back pain, injury, and muscle/nerve pain were identified as the highest contributors to the excess use observed among adults with obesity.

According to the researchers, the findings indicate that future investments in chronic pain reduction may benefit from increased integration with obesity prevention and treatment.

The second study, which was published in JAMA Open Network, looked at the pain conditions underlying this increased likelihood of opioid prescriptions for individuals with higher BMIs.  

For the study, the researchers analyzed electronic health record (EHR) of 565,930 patients to determine the association between obesity and pain diagnoses recorded as reasons for opioid prescriptions. EHRs of patients seen by primary care clinicians in the United States in the multipayer athenahealth network from January 1, 2015 to December 31, 2017 were reviewed and data were analyzed from March 1 to September 15, 2019.

Among the patients in the study, the risk of receiving prescription opioids increased progressively with BMI, and the percentage of patients with opioid prescriptions attributable to an overweight or obese BMI was 16.2% (95% CI, 15.0%-17.4%).

Osteoarthritis, other joint disorders, and other back disorders were the most prominent pain diagnoses associated with increased prescribing of opioids to patients with obesity, according to the findings.  

“Addressing the opioid crisis will require attention to underlying sources of demand for prescription opioids, including obesity, through its associations with pain,” the researchers concluded in the study.

References:

1. Stokes A, Lundberg DH, Hempstead K, et al. Obesity and incident prescription opioid use in the US, 2000-2015. American Journal of Preventive Medicine. 2020. Doi: https://doi.org/10.1016/j.amepre.2019.12.018

2. Stokes A, Lundberg DH, Sheridan B, et al. Association of obesity with prescription opioids for painful conditions in patients seeking primary care in the US. JAMA Network Open. 2020. Doi: 10.1001/jamanetworkopen.2020.2012