Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Opioid Prescribing in Veterans with Cirrhosis

Clin Gastroenterol Hepatol; ePub 2018 Oct 17; Rogal, et al

Among veterans with cirrhosis, 36‒47% were prescribed opioids in each year from 2005-2014, with mental health disorders and hepatic decompensation independently associated with long-term opioid prescriptions. This according to a recent study that aimed to assesses time trends in opioid prescribing and factors associated with receiving opioids among patients with cirrhosis. Using National Veterans Health Administration data (2005-2014), researchers assessed characteristics of patients and their prescriptions for opioids and calculated the annual proportion of patients receiving any opioid prescription. They found:

  • Among 127,239 veterans with cirrhosis, 97,974 (77.0%) received a prescription for an opioid.
  • Annual opioid prescriptions increased from 36% in 2005 to 47% in 2014.
  • The proportions of those receiving long-term prescriptions increased from 47% in 2005 to 54% in 2014, and 19‒21% received prescriptions for high-dose opioids.
  • Prescriptions for combinations of opioids and acetaminophen decreased during the study period, as did combinations of opioids and benzodiazepines.
  • Greater probability of long-term opioid prescriptions was independently associated with younger, age, female sex, white race, hepatitis C, mental health disorders, prior hepatic decompensation, and pain-related conditions.


Rogal SS, Beste LA, Youk A, et al. Characteristics of opioid prescriptions to veterans with cirrhosis. [Published online ahead of print October 17, 2018]. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2018.10.021.