Trends in Prescription Opioid Use in Motor Vehicle Crash Injuries in the United States: 2014–2018

Motor vehicle crashes (MVC) cause over three million people to be nonfatally injured each year in the United States alone. We investigated trends and patterns in prescription opioid usage among nonfatal MVC injuries in 50 states in the US and the District of Columbia from 2014 to 2018. All emergency department visits for an MVC event (N = 142,204) were identified from the IBM(®) MarketScan(®) Databases. Using log-binomial regression models, we investigated whether the prevalence of prescription opioids in MVC injuries varied temporally, spatially, or by enrollees’ characteristics. Adjusting for age, relationship to the primary beneficiary, employment status, geographic region, and residence in metropolitan statistical area, the prevalence decreased by 5% (95% CI: 2–8%) in 2015, 18% (95% CI: 15–20%) in 2016, 31% (95% CI: 28–33%) in 2017, and 49% (95% CI: 46–51%) in 2018, compared to 2014. Moreover, the prevalence decreased by 28% (95% CI: 26–29%) after the publication of the CDC Guidelines for Prescribing Opioids for Chronic Pain. Spatial variations were observed in the prevalence and temporal trend of prevalence. The decreasing trend in the prevalence of prescription opioids in MVC is consistent with the decrease in the dispensing rate of opioids and the percentage of high-dosage opioids in the study population.