Trends in Opioid Prescriptions Based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) Database From 2008 to 2022.

BACKGROUND: Opioid prescription practices in the United States have changed substantially over the past 25 years in response to government policies, medical guidelines, and the opioid epidemic. METHODOLOGY: The Medical Information Mart for Intensive Care IV (MIMIC-IV) version 3.1 database comprises de-identified patient encounters from Beth Israel Deaconess Medical Center (BIDMC) in Massachusetts, United States. Data were analyzed using Structured Query Language (SQL) via Google BigQuery. Patients were grouped into three-year cohorts to further protect confidentiality. RESULTS: Between 2008 and 2022, data from 364,627 patient admissions were evaluated, including 1,150,944 opioid prescriptions. The percentage of patients receiving opioids decreased from 46.5% (47,273 of 101,607) in the 2008-2010 cohort to 33.6% (16,545 of 49,173) in the 2020-2022 cohort. The number of prescriptions per patient also decreased, from 9.9 in the 2008-2010 cohort to 5.8 in the 2020-2022 cohort. Furthermore, the total prescribed strength per patient decreased from 829 morphine milligram equivalents (MME) in the 2008-2010 cohort to 508 MME in the 2020-2022 cohort. These decreases were consistent across all cohorts during the study period. CONCLUSIONS: These findings are consistent with other studies from the United States and internationally demonstrating declines in the volume and potency of opioid prescriptions during this period. Despite these reductions, opioid-related deaths increased over the same period. These trends persisted across the recognized waves of the opioid epidemic. Although previous studies have reported opioid prescription data from the MIMIC database, our findings provide the most up-to-date analysis spanning the opioid epidemic.