A new study has found that combining prescribed central nervous system stimulants, such as those used to treat ADHD symptoms, with prescribed opioid medications is linked to increased opioid intake over time. The research analyzed health insurance claims data from nearly 3 million US patients and explored how these two types of drugs interacted over a decade.
“We know that combining the two drugs can increase the risk for overdose deaths,” said Ping Zhang, senior study author and associate professor of computer science and engineering at Ohio State University. “But we didn’t know whether stimulant use has a causal role in high opioid use. So, we conducted a big data analysis to examine how these patterns interacted over time.”
The researchers identified 2.9 million patients aged an average of 44 who had received at least two independent opioid prescriptions between 2012 and 2021 from the MarketScan Commercial Claims database. They then established a cohort based on this data, examining their monthly intake of opioids using morphine milligram equivalents (MME) calculations.
Of these patients, 5.5% were also prescribed stimulants during the study period. The researchers found that those who took both drugs generally had higher opioid doses and were more likely to increase their usage over time. They identified five groups based on dosage trajectory: very low-dose, low-dose decreasing, low-dose increasing, moderate-dose increasing, and high-dose sustained use.
The study also found that patients with ADHD or chronic pain who received both stimulants and opioids had higher opioid intake compared to those without these conditions. Additionally, males had higher average daily opioid intakes than females, while regions in the South and West of the US showed higher total opioid intakes over time.
The findings suggest that regulation of stimulant prescribing may be needed for patients already taking prescription opioids, as this could help reduce the risk of adverse drug events associated with co-using these medications. Zhang’s team plans to use their research to develop safer personalized treatment recommendations using AI in medicine.
