A study analyzing Medicaid data from 2001 to 2019 found shifts in prescribing trends for controlled medications, with declines in opioids, benzodiazepines and Z-hypnotics, but rising stimulant and gabapentin use among young adults. The findings underscore both improved prescribing caution and emerging concerns for misuse.
The study was published Dec. 15 in Drug and Alcohol Dependence and led by researchers from Piscataway, N.J.-based Rutgers University, New York City-based Columbia University and New York City-based New York University. Researchers examined Medicaid claims from 17.9 million enrollees ages 10-29 across 43 states, focusing on individuals enrolled for at least 10 months annually. They assessed annual prevalence of prescriptions for opioids, stimulants, benzodiazepines, Z-hypnotics, barbiturates and gabapentin, focusing on individuals enrolled at least 10 months per year.
Here are six takeaways:
- The proportion of adults ages 18-24 with at least one opioid prescription fell from a peak of 29.8% in 2010 to 11.2% in 2019. Adolescents saw a similar drop, from 14.3% in 2003 to 4.4% in 2019.
- Stimulant prescriptions rose eightfold among adults ages 25-29, from 0.3% in 2001 to 2.6% in 2019. Among 18- to 24-year-olds, prescriptions quadrupled over the same period.
- Prescriptions for sedatives rose through the mid-2000s but began declining after 2010, especially following FDA safety warnings and overdose concerns. Z-hypnotic prescribing dropped from 3.3% in 2010 to 0.6% in 2019 for the 25 to 29 age group.
- While still low in adolescents, gabapentin prescriptions for the 25 to 29 age group doubled from 1.5% to 3% between 2001 and 2019.
- The proportion of individuals prescribed two or more controlled medication classes declined across all age groups. In adults ages 25-29, this fell from 12.3% in 2010 to 4.8% in 2019.
- Among 10- to 12-year-olds, stimulants prescriptions rose from 7.6% in 2001 to 11.2% in 2013, followed by a decline to 9.9% in 2019. Opioid prescriptions in this group dropped to 1.5%.
