Keywords: spinal cord injury, opioid, propensity score matching
While opioid prescriptions after spinal cord injury (SCI) are common, opioid utilization patterns in SCI are not well characterized. We analyzed 2012-2013 MarketScan data from persons aged 18-64 with at least one opioid prescription in 2012 and 18 months of insurance coverage after the first filled opioid prescription in 2012. The final sample consisted of 1,868 persons with SCI and 1,868 controls with comparable characteristics (e.g., age, comorbidities, gender, etc.) as determined by propensity score matching. Multivariate logistic regressions, based on 12-months of post-index data, showed the SCI cohort was significantly more likely (OR=2.15, p<0.01) to be prescribed short acting opioids long term (>90 days), and was significantly more likely (OR=3.25, p<0.01) to be prescribed high morphine equivalent (ME) doses (120+ mg/day) of long acting opioids than controls. Findings show persons with SCI are prescribed opioids for longer durations of time and at higher ME doses than controls, which may increase risk of opioid dependence or adverse drug events. Future policies should consider alternate pain management options or opioid dependence interventions for persons with SCI.