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Over 40% of older adults with rheumatic diseases filled at least one opioid prescription in 2021, and nearly 1 in 5 met criteria for chronic use. Patients with axial spondyloarthritis and those in the most socioeconomically deprived neighborhoods faced the highest odds of chronic opioid use. Notably, most opioid prescriptions were written by non-rheumatology clinicians, pointing to a need for cross-specialty coordination.
A large cross-sectional study of Medicare-linked data found that opioid use is widespread among older adults with rheumatic diseases — and chronic use is far from rare. Analyzing over 45,000 patients aged 65 and older in 2021, researchers found that more than 43% filled at least one opioid prescription, while nearly 18% met the threshold for chronic opioid use (90+ days' supply in a year).
The picture gets more nuanced when you look at who's most at risk. Patients with axial spondyloarthritis (axSpA) were 63% more likely to be chronic opioid users compared to those with rheumatoid arthritis, while those living in the most socioeconomically deprived neighborhoods were nearly twice as likely. Fibromyalgia, mood disorders, and anxiety were also independently linked to higher chronic use.
By the Numbers:
Why it matters: Most opioid prescriptions for these patients are coming from outside rheumatology, which means siloed care could be driving avoidable chronic exposure. The authors call for shared care models and better cross-specialty communication to tackle this problem head-on.
