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Association Between Opioid Use and Health Care Utilization as Measured by Emergency Room Visits and Hospitalizations Among Persons Living With HIV

Koeppe, John MD*; Lyda, Karen NP; Armon, Carl PhD

doi: 10.1097/AJP.0b013e31827c7b05
Original Articles

Background: Epidemiologic studies in the non–human immunodeficiency virus (HIV) positive population have shown greater health care utilization among persons with chronic non-cancer pain on opioid therapy. However, we are not aware of any similar data in the HIV positive population.

Methods: We evaluated health care utilization, as measured by emergency room (ER) visits and hospitalizations, among persons with HIV and chronic pain seen at an academic medical center, during the calendar year 2005. We compared these outcomes between patients on chronic opioid therapy with those not on opioids.

Results: In univariate models chronic opioid therapy was associated with both ER visits and hospitalization: ER visits odds ratio (OR)=2.18 (95% confidence interval [CI], 1.30-3.66), hospitalization OR=1.90 (95% CI, 1.03-3.51). After multivariate analyses only nonsignificant trends remain: ER visits OR=1.71 (95% CI, 0.95-3.08); hospitalization OR=1.28 (95% CI, 0.66-2.49).

Conclusions: In our study HIV positive individuals with chronic pain were more likely to be seen in the ER and be hospitalized if they were on opioids. However, after controlling for other variables, the association with opioids no longer remained significant.

Supplemental Digital Content is available in the text.

Divisions of *General Internal Medicine

Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, CO

Department of Epidemiology, Children’s Hospital Colorado, Aurora

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The authors declare no conflict of interest.

Reprints: John Koeppe, MD, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado, 1635 Aurora Court, F-729, Aurora, CO 80045 (e-mail:

Received May 9, 2012

Accepted November 4, 2012

© 2013 by Lippincott Williams & Wilkins