This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain.

The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life.

Most decedents (61.5%) had received clinical diagnoses of chronic noncancer pain conditions in the last year of life. As compared with decedents without chronic pain diagnoses, those with these diagnoses were significantly more likely to have filled prescriptions for opioids (49.0% versus 17.2%) and benzodiazepines (52.1% versus 26.6%) during the last 30 days of life, while diagnoses of opioid use disorder during this period were uncommon in both groups (4.2% versus 4.3%). The chronic pain group was also significantly more likely than the nonpain group to receive clinical diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life.

Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.

这项研究分析了医疗补助计划中非老年人类阿片类药物相关死亡之前的卫生服务模式，重点研究了有或没有去年诊断为非癌性慢性疼痛的后遗症。

作者在医疗补助计划中确定了年龄≤64岁的与阿片类药物有关的后遗症，并对其死亡前30天和12个月内的临床诊断，药物处方和非致命性中毒事件进行了描述。该研究组包括13089例与阿片类药物相关的死亡，根据生命的最后一年中是否存在慢性非癌性疼痛诊断进行了划分。

大多数死者（61.5％）在生命的最后一年接受了慢性非癌性疼痛状况的临床诊断。与没有慢性疼痛诊断的后遗症相比，具有这些诊断结果的后遗症在生命的最后30天中更有可能接受阿片类药物（49.0％对17.2％）和苯二氮卓类药物（52.1％对26.6％）的处方。在此期间，阿片类药物使用障碍在两组中均很少见（4.2％对4.3％）。在过去一年中，慢性疼痛组比非疼痛组接受临床诊断药物使用（40.8％对22.1％），抑郁症（29.6％对13.0％）或焦虑症（25.8％对8.4％）的可能性要高得多。生活。

死于阿片类药物相关病因的人，特别是那些被诊断出患有慢性疼痛的人，在生命的最后一年通常接受与药物使用障碍和精神障碍有关的服务，尽管在死亡时诊断出的阿片类药物使用障碍很少见。