Journal article
Rural-urban differences in opioid prescribing in the Veterans Health Administration
The Journal of rural health, Vol.41(1), e70014
01/2025
DOI: 10.1111/jrh.70014
PMID: 40062641
Abstract
To determine whether higher rates of opioid prescribing among rural Veterans in the Veterans Health Administration (VHA), previously observed through 2016, persisted through 2023.
National VHA administrative data were used to contrast opioid prescribing between urban and rural Veterans for annual veteran cohorts from 2016 through 2023. The primary prescribing metric was per capita volume expressed as morphine milligram equivalents (MME). Prescribing metrics were contrasted between urban and rural Veterans using Wilcoxon signed rank tests and odds-ratios.
Per capita opioid prescribing was 35% higher among rural Veterans (1275 MME) than urban Veterans (943 MME) in 2016. While overall volume decreased markedly by 2023, opioid prescribing remained higher among rural Veterans (391 MME vs. 270 MME), by 45%. The largest difference was attributable to long-term recipients, which accounted for 325 MME of the 332 MME difference (98%) during 2016 and 118 of the 121 MME difference (98%) in 2023.
Higher rates of opioid prescribing among rural Veterans have persisted through 2023, largely driven by differences in long-term prescribing. This may indicate a need for enhanced access to nonpharmacological management options for chronic pain among rural Veterans. Leveraging existing resources within VHA such as the Whole Health System may enhance pain care for rural Veterans.
Details
- Title: Subtitle
- Rural-urban differences in opioid prescribing in the Veterans Health Administration
- Creators
- Rena E Courtney - Salem VA Medical CenterBrian C Lund - University of IowaKatherine Hadlandsmyth - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.41(1), e70014
- DOI
- 10.1111/jrh.70014
- PMID
- 40062641
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Publisher
- WILEY
- Grant note
- Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center-Iowa City: 03857 US Department of Veterans Affairs Health Services Research and Development (HSR&D) Service through the Center for Access and Delivery Research and Evaluation (CADRE) Center: CIN 13-412 VISN 6 Career Development Award
This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (Award # 03857). The work reported here was also supported by the US Department of Veterans Affairs Health Services Research and Development (HSR&D) Service through the Center for Access and Delivery Research and Evaluation (CADRE) Center (CIN 13-412). This was also supported with resources and the use of facilities at the Salem VA Health Care System and author RC is supported by funding through a VISN 6 Career Development Award.
- Language
- English
- Date published
- 01/2025
- Academic Unit
- Psychiatry; Epidemiology; Anesthesia
- Record Identifier
- 9984799686602771
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