US Trends of Opioid-use Disorders and Associated Factors Among Hospitalized Patients With Spinal Conditions and Treatment From 2005 to 2014

Serial cross-sectional study utilizing the National Inpatient Sample (NIS) 2005 to 2014. OBJECTIVE. The aim of this study was to examine the trends of opioid-use disorders among hospitalized patients with spinal conditions and treatment and to identify its contributing factors. SUMMARY OF BACKGROUND DATA. The opioid is widely used in chronic spinal conditions, and misuse of prescriptions is the main culprit of the opioid crisis. Cannabis, the most commonly utilized illicit drug, has recently been substituted for opioid despite increasing cannabis-use emergency room visits. There is limited information on opioid-use disorders, the association with cannabis, and other contributing factors. METHODS. We analyzed the 2005 to 2014 NIS data that identified opioid-use disorders among hospitalized patients with cervical and lumbar spinal conditions and treatment using the International Classification of Disease, Ninth Revision-Clinical Modification codes for opioid abuse, dependence, poisoning, and cervical and lumbar spinal diseases and procedures. The compound annual growth rate (CAGR) was used to quantify trends of opioid-use disorders among hospitalized patients. Multilevel and multivariable regression analyses were performed to determine their contributing factors. RESULTS. The number of hospitalizations with spinal conditions and treatment increased from 2005 to 2011, then decreased between 2011 and 2014 with an overall decrease in length of stay, resulting in the CAGR of −1.60% (P < .001). Almost 3% (2.93%, n = 557,423) of hospitalized patients with spinal conditions and treatment were diagnosed as opioid-use disorders and its CAGR was 6.47% (P < .0001). Opioid-use disorders were associated with cannabis-use disorders (odds ratio 1.714), substance use, mental health condition, younger age, white race, male sex, higher household income, and public insurance or uninsured. CONCLUSION. This study suggests that opioid-use disorders are increasing among hospitalized patients with spinal conditions and treatment and associated with several demographic, and socioeconomic factors, including cannabis-use disorders. Level of Evidence: 3