The following is a summary of “Prescription opioid dispensing patterns among patients with schizophrenia or bipolar disorder,” published in the April 2024 issue of Psychiatry by Roy et al.

Schizophrenia (SZ) and bipolar disorder (BD) patients might face higher risks from opioid medications due to potential breathing problems.

Researchers started a retrospective study to examine trends in prescription opioid pain medication dispensing for patients with SZ or BD compared to controls over five years.

They examined US claims data from IBM® MarketScan® Commercial and Multi-State Medicaid databases. They focused on individuals aged 18–64 with prevalent SZ or BD from 2015 to 2019, comparing them with age—and sex-matched controls. The study assessed baseline characteristics, comorbidities, and medication use. The analysis focused on the proportions of individuals receiving prescription opioids chronically (defined as ≥70 days over 90 days or ≥ 6 prescriptions annually) or nonchronically (with at least one prescription but not meeting the chronic definition).

The results showed that in 2019 the Commercial and Medicaid databases contained records for 4,773 and 30,179 patients with SZ and 52,780 and 63,455 patients with BD, respectively. Patients with SZ or BD had a higher prevalence of comorbidities, including pain, compared to controls in each analysis year. From 2015 to 2019, among commercially insured patients with SZ, chronic opioid-dispensing proportions decreased from 6.1% (controls: 2.7%) to 2.3% (controls: 1.2%) and, for patients with BD, from 11.4% (controls: 2.7%) to 6.4% (controls: 1.6%). Chronic opioid dispensing declined in Medicaid-covered patients with SZ from 15.0% (controls: 14.7%) to 6.7% (controls: 6.0%) and, for patients with BD, from 27.4% (controls: 12.0%) to 12.4% (controls: 4.7%). Among commercially insured patients with SZ, non-chronic opioid dispensing decreased from 15.5% (controls: 16.4%) to 10.7% (controls: 11.0%) and, for patients with BD, from 26.1% (controls: 17.5%) to 20.0% (controls: 12.2%). In Medicaid-covered patients with SZ, non-chronic opioid dispensing declined from 22.5% (controls: 24.4%) to 15.1% (controls: 12.7%) and, for patients with BD, from 32.3% (controls: 25.9%) to 24.6% (controls: 13.6%).

Investigators concluded that while both commercial and Medicaid-insured patients with SZ or BD received opioids more often than control groups, the overall rates of chronic and non-chronic opioid use declined between 2015 and 2019 for all groups.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05676-5