Reproductive-age women widely prescribed opioid medications

Opioid-containing medications are widely prescribed among reproductive-age women with either private insurance or Medicaid, with approximately one-fourth of privately insured and more than one-third of Medicaid-enrolled women filling a prescription for an opioid each year from 2008 to 2012.

Researchers at the Centers for Disease Control and Prevention's National Center on Birth Defects and Developmental Disabilities used a commercially available database comprising a convenience sample of employed persons with private employer-sponsored insurance and their dependents, as well as an annual sample of Medicaid data, to assess outpatient pharmacy prescription drug claims for opioids among women ages 15 to 44.

Results appeared in MMWR on Jan. 23.

There were between 4.4 million and 6.6 million privately insured and 400,000 to 800,000 Medicaid-enrolled reproductive-age women in the study sample each year from 2008 to 2012. Of these, an average 27.7% of privately insured and 39.4% of Medicaid-enrolled women filled a prescription for an opioid from an outpatient pharmacy each year (P<0.001). Opioid prescription claims were highest in 2009, with 29.1% of privately insured women and 41.4% of Medicaid-enrolled women filling a prescription for an opioid.

Opioid prescription claims were consistently higher among Medicaid-enrolled women when compared with privately insured women each year of the study. In 2012, there were 0.7 and 1.6 prescriptions filled per woman among privately insured and Medicaid-enrolled women, respectively. Of those who filled an opioid prescription, an average of 2.6 and 4.3 prescriptions were filled, respectively.

The most commonly prescribed opioids were hydrocodone (17.5% of privately insured and 25% of Medicaid-enrolled women annually), codeine (6.9% and 9.4%), and oxycodone (5.5% and 13%). Privately insured women ages 30 to 34 and Medicaid-enrolled women ages 40 to 44 were most likely to fill prescriptions for opioids. Women ages 15 to 19 were least likely to fill a prescription for an opioid, regardless of the type of insurance.

The authors noted that the consistently higher frequency of opioid prescribing to Medicaid-enrolled women is of concern because they deliver about half of all births.

“Many women need to take opioid-containing medications to appropriately manage their health conditions; however, in some instances safer alternative treatments are available and use of opioids is unnecessary,” the authors concluded. “Having a better understanding of prescription opioid use just before and during early pregnancy can help inform targeted interventions to reduce unnecessary prescribing of opioids and provide evidence-based information to health care providers and women about the risks of prenatal opioid exposure.”