Opioid prescriptions remain high despite increased awareness of the opioid epidemic and awareness of the drugs’ risks, a new study finds.

Researchers found opioid use and doses leveled off after peaking in 2012-13, but were still higher in 2017 than in 2007, HealthDay reports. Opioid use was especially high in elderly patients with chronic pain, the researchers report in BMJ.

Much of the extended opioid use among older patients is for lower back pain, said lead researcher Molly Moore Jeffery. But for most patients, over-the-counter painkillers combined with physical therapy are more effective, she noted.

The study compared opioid prescriptions among commercially insured patients; Medicare Advantage recipients 65 and older; and Medicare Advantage beneficiaries younger than 65, who generally qualify because of long-term disability. They found that over the course of one year, 14 percent of commercially insured patients, 26 percent of Medicare Advantage patients 65 and older, and 52 percent of disabled Medicare Advantage patients received an opioid prescription.