As public awareness of the opioid crisis grew in the early 2010s, the health care community was primarily focused on the overprescribing of opioids to treat acute and chronic pain. At the time, relatively little was known about the important phase between prescribing an opioid for acute pain and long-term opioid use.
DHS analyzed Medicaid and MinnesotaCare claims data to develop a better understanding of how often patients transitioned from acute to chronic use. DHS found that nearly 5% of Medicaid enrollees were transitioning from no opioid use to long-term (chronic) use in any given year. Between 2011 and 2014, the number of ‘new chronic users’ in the Medicaid and MinnesotaCare patient population increased by 31% (from 4708 to 6186 respectively). Through this work, DHS created a system-level measure of transition from opioid use for acute pain to chronic opioid use, the new chronic user measure (NCU).
Preventing the transition from opioid use for acute pain to long-term opioid use is a key part of DHS’ approach to addressing the prescription opioid element of the opioid use crisis. Identifying patients before they transition to long-term opioid use creates an opportunity to reduce opioid dependence, and potentially opioid use disorder. The OPIP program emphasizes the post-acute pain period and the prevention of long-term opioid use for chronic pain throughout all of the program components, in addition to safe and judicious opioid prescribing in the acute and chronic pain phases.