Concomitant use of prescription opioids and psychotropic medications: analysis of Mississippi Medicaid members.

OBJECTIVES

To estimate the prevalence and intensity of concomitant opioid and psychotropic medication use in Mississippi Medicaid members.

METHODS

This cross-sectional study used Mississippi Medicaid claims from 2016 to 2021 and examined members who filled at least one opioid prescription in a given year. The prevalence and intensity of concomitant opioid-psychotropic use, along with demographic characteristics, chronic non-cancer pain (CNCP) diagnoses, mental health diagnoses, and long-term opioid therapy (LTOT) among members were estimated annually.

RESULTS

The eligible sample declined from 82,550 in 2016 to 51,583 in 2021, with CNCP diagnoses at 21% to 24% and LTOT use at 16% to 9%. Concomitant use prevalence was 33.3% in 2016 and 33.8% in 2021, with antidepressants (range: 14.46%-17.04%) and muscle relaxants (range: 13.92%-15.49%) being the most commonly used concomitant medications. Concomitant benzodiazepine use decreased over time (from 9.42% to 3.04%). Concomitant use intensity increased from 76.7% in 2016 to 84.3% in 2021, with mean increases for all studied medications.

CONCLUSIONS

Despite reductions in opioid use, the stable prevalence and rising intensity of psychotropic medication overlap highlight a growing reliance on multimodal pharmacologic approaches. These findings underscore the importance of coordinated prescribing, ongoing monitoring, and targeted interventions to mitigate risks in vulnerable populations.