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- Title
Patterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study.
- Authors
Rentsch, Christopher T.; Edelman, E. Jennifer; Justice, Amy C.; Marshall, Brandon D. L.; Xu, Ke; Smith, Andrew H.; Crystal, Stephen; Gaither, Julie R.; Gordon, Adam J.; Smith, Rachel V.; Kember, Rachel L.; Polimanti, Renato; Gelernter, Joel; Fiellin, David A.; Tate, Janet P.; Kranzler, Henry R.; Becker, William C.
- Abstract
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). We extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. Using latent growth mixture modelling, we identified four distinguishable dose trajectories: low (53%), moderate (29%), escalating (13%), and rapidly escalating (5%). Compared to low dose trajectory, those in the rapidly escalating dose trajectory were proportionately more European-American (59% rapidly escalating vs. 38% low); had a higher prevalence of HIV (31% vs. 29%) and hepatitis C (18% vs. 12%); and during follow-up, had a higher incidence of OUD diagnoses (13% vs. 3%); were hospitalised more often [18.1/100 person-years (PYs) vs. 12.5/100 PY]; and had higher all-cause mortality (4.7/100 PY vs. 1.8/100 PY, all p < 0.0001). These measures can potentially be used in future prevention research, including genetic discovery.
- Subjects
UNITED States; SUBSTANCE abuse prevention; CHI-squared test; DRUGS; DRUG prescribing; HEPATITIS C; HIV-positive persons; HOSPITAL care; MORTALITY; NARCOTICS; SCIENTIFIC observation; UNITED States. Dept. of Veterans Affairs; PSYCHOLOGY of veterans; PHENOTYPES; PAIN management; PHYSICIAN practice patterns; DATA analysis software; ELECTRONIC health records; DESCRIPTIVE statistics; KRUSKAL-Wallis Test
- Publication
AIDS & Behavior, 2019, Vol 23, Issue 12, p3340
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-019-02608-3