Heightened risks of dependence, addiction, anxiolytic effects, or prescription overdose death due to long-term use of pain medication, have increased awareness about extended pain medication use in chronic pain populations. The goal of this study was to evaluate the incidence and prevalence of pain medication prescriptions from 2012 to 2022 in common pathologies with a potential for chronic pain.
A retrospective cohort study was conducted using electronic health records from TriNetX Global Collaborative Network. For ten distinct cohorts (total N=9,357,584 patients), pain medication prescriptions were extracted for five classes, namely NSAIDs/acetaminophen, opioids, gabapentinoids, neuropathic mood agents and muscle relaxants. Annual incidence and prevalence of each class of medication was evaluated for the past 11 years.
From 2012 to 2022, there was a significant increase in prescriptions of NSAIDs, except for patients with fibromyalgia, and Persistent Spinal Pain Syndrome (PSPS-T2). Interestingly, over time, prescriptions of opioids in patients with complex regional pain syndrome, endometriosis, osteoarthritis and PSPS-T2 increased, as did prescriptions of muscle relaxants for all cohorts except those with fibromyalgia. Incidence of prescriptions of neuropathic mood agents is high for patients with complex regional pain syndrome (both types) and PSPS-T2. Only for benzodiazepines did there seem to be a decline over the years, with a significantly decreased time trend in patients with complex regional pain syndrome type 1, fibromyalgia and PSPS-T2.
Over the last 11 years, an increase in incidence of NSAIDs/acetaminophen, opioids, neuropathic agents, and muscle relaxants was observed. Only prescriptions of benzodiazepines significantly decreased over time in specific cohorts. Overall, patients with PSPS-T2 and complex regional pain syndrome (both types) consume a broad variety of pain medication classes.