Table 2

Odds of early and long-term opioid use by initial provider

Early use, OR (95% CI)Long-term, OR (95% CI)
Initial providerPT (n=3499)0.15 (0.13 to 0.17)0.27 (0.15 to 0.48)
DC (n=50 014)0.10 (0.09 to 0.10)0.22 (0.18 to 0.26)
Acupuncture (n=1839)0.09 (0.07 to 0.12)0.07 (0.01 to 0.48)
Ortho (n=9335)0.63 (0.60 to 0.67)1.10 (0.92 to 1.30)
Emerg Med (n=8746)2.66 (2.54 to 2.78)0.92 (0.77 to 1.10)
Neurosgn (n=578)0.58 (0.47 to 0.71)1.50 (0.88 to 2.58)
MD other (n=4422)0.50 (0.46 to 0.54)2.03 (1.70 to 2.41)
Rehab (n=3246)0.54 (0.49 to 0.59)1.78 (1.40 to 2.26)
Age (years)45–64 vs 18–441.07 (1.05 to 1.10)1.32 (1.19 to 1.46)
65–74 vs 18–440.89 (0.82 to 0.97)0.79 (0.54 to 1.15)
75+ vs 18–440.80 (0.72 to 0.89)0.67 (0.45 to 1.00)
Sex/genderFemale vs male0.83 (0.81 to 0.85)0.82 (0.76 to 0.89)
RaceAsian vs white0.49 (0.46 to 0.52)0.29 (0.20 to 0.42)
Black vs white0.90 (0.87 to 0.94)0.87 (0.76 to 0.99)
Hispanic vs white0.79 (0.76 to 0.82)0.69 (0.59 to 0.81)
Unknown vs white0.84 (0.79 to 0.89)0.65 (0.51 to 0.83)
RegionMidwest vs Northeast0.78 (0.75 to 0.81)0.74 (0.64 to 0.87)
South vs Northeast1.11 (1.08 to 1.14)1.22 (1.11 to 1.34)
West vs Northeast1.01 (0.97 to 1.04)1.17 (1.02 to 1.34)
Insurance typeMedicare <65 years vs commercial insurance0.98 (0.89 to 1.08)3.77 (3.19 to 4.46)
Medicare ≥65 years vs commercial insurance0.98 (0.89 to 1.08)2.24 (1.54 to 3.26)
ComorbiditiesAnxiety1.05 (1.01 to 1.09)1.46 (1.30 to 1.63)
Bipolar disorder1.11 (1.01 to 1.21)1.41 (1.13 to 1.76)
Depression1.11 (1.07 to 1.15)1.55 (1.39 to 1.73)
Dementia0.80 (0.70 to 0.92)0.99 (0.73 to 1.36)
ADHD0.87 (0.80 to 0.95)1.00 (0.75 to 1.32)
Alcohol use disorder1.08 (0.98 to 1.20)1.28 (0.98 to 1.66)
Substance use disorder1.06 (0.93 to 1.22)2.34 (1.76 to 3.10)
Fibromyalgia/chronic pain/fatigue0.96 (0.92 to 1.01)1.92 (1.71 to 2.16)
PTSD0.84 (0.69 to 1.03)1.16 (0.77 to 1.77)
Psychotic disorder0.86 (0.74 to 0.99)0.76 (0.55 to 1.05)
Elixhauser physical1.07 (1.06 to 1.08)1.24 (1.21 to 1.27)
  • The following variables were all included in the regression: age, sex/gender, race/ethnicity, insurance, Elixhauser, which included physical comorbidities and mental health comorbidities. PCP is the reference group (n=114 782); adjusted for race/ethnicity, sex/gender, region and insurance type. Two additional initial providers—other non-MD (eg, physician assistants, advance practice nurses) and radiologist—were included in the analyses but not reported in this table.

  • *P<0.01.

  • ADHD, attention deficit hyperactivity disorder; DC, chiropractor; Emerg Med, emergency medicine physician; MD other, other physician; Neurosgn, neurosurgeon; Ortho, orthopaedic surgeon; PCP, primary care physician; PT, physical therapy; PTSD, post-traumatic stress disorder; Rehab, rehab physician.