Image of Hemalkumar B. Mehta, Ph.D.

Differences between states’ rates of chronic opioid use among nursing home residents dropped by a third from 2014 to 2018, a new study finds.

Researchers examined data from the nursing home Minimum Data Set and Medicare claims for more than 1.5 million long-stay residents (at least 120 consecutive days). They analyzed the proportion of variation in chronic opioid use that is attributable to states or to nursing homes, defining chronic opioid use among residents as use for 90 or more days. Each year’s results were controlled for resident, nursing home and state characteristics.

“Variation in chronic opioid use declined by one-third at the state level but not at the nursing home level,” reported first author Hemalkumar B. Mehta, Ph.D., of the Johns Hopkins Bloomberg School of Public Health and coauthors. Chronic opioid use declined from 14% in 2014 to 11% in 2018, they found. The variation in use among states also declined from 3% in 2014 to 2% in 2018. In contrast, the variation among nursing homes increased from 6% in 2014 to 7% in 2018.

The changes in state-level variation may reflect the response to national guidelines and federal policies on opioid use as regulations evolved from being primarily state- to federally based, Mehta and colleagues concluded.

The study was published online ahead of print in the Journal of the American Medical Directors Association.