Use of opioid analgesics in skin disorders: Results from a nationally representative US sample

Abstract

Introduction: Increasing and inappropriate use of opioid analgesics (OA) have been declared a public health concern in the United States. There are no epidemiologic studies of OA use in skin disorders. We examined OA use in a nationally representative sample of US patient visits with only physician-diagnosed skin disorders.

Methods: Retrospective cross-sectional study of 56 751 patient visits from 1995 to 2010 (International Classification of Diseases, 9th Revision, Clinical Modification codes 680–709 denoting “Diseases of the Skin and Subcutaneous Tissue”; 172, 173, 216 and 232 denoting malignant and benign skin neoplasms).

Results: An estimated 3.1% ± 0.2% of skin disorders visits were associated with OA use; 52.7% ± 5.4% were Schedule III opioids; 11.4% ± 1.4% of OA visits involved skin neoplasms and 45.4% ± 2.3% cellulitis and abscess. OA use increased from 1995 to 2010 (adjusted OR = 1.82, 95% CI: 1.49–2.22), even after controlling for increase in the frequency of skin infections from 1995 to 2010.

Discussion: The most frequent use OA for cellulitis and abscess is entirely consistent with their Food and Drug Administration (FDA)-approved indications for pain management. The almost two-fold increase in OA use in skin disorders from 1995 to 2010 may suggest that OA are being considered for pain management earlier in therapy.

Conclusions: Only a minority of patient visits with OA had primary dermatologic disease. OA are being used in dermatology primarily for FDA-approved indications.

• Dermatology
• epidemiology
• narcotics
• opioid analgesics
• pain
• skin cancer
• skin disease

Declaration of interest

The authors have no conflicts of interest to declare. There was no external funding for compiling the database upon which the study is based.