Opioid and Potentiator Co-Use Common in US Nursing Home Residents

Researchers linked 2019 Minimum Data Set 3.0 assessments with Medicare Part D claims and other data to examine opioid use among 135,347 long-stay nursing home residents. In this cross-sectional analysis, opioid use was categorized by duration during the 120 days after an index assessment: short-term (30 days or less), medium-term (31–89 days), and long-term (90 days or more). The study also assessed resident- and facility-level correlates of use and co-use with benzodiazepines, non-benzodiazepines, or gabapentinoids.

Overall, 32,550 residents (24.0%) had opioid prescriptions: 7.1% of all residents were short-term users, 5.5% medium-term users, and 11.4% long-term users. Among opioid users, 52.0% also had a prescription for an opioid potentiator. Gabapentinoids were the most frequently used potentiator class, followed by benzodiazepines and non-benzodiazepines. Pain and comorbid conditions including anxiety were associated with use; cognitive impairment and dementia were associated with lower odds of opioid use and co-use.

The findings document prescribing patterns, not whether co-use caused harm or improved pain control. The authors emphasize medication reviews and consideration of alternatives, but this observational study does not establish which strategies reduce adverse outcomes.