Characteristics of initial prescription episodes and likelihood of long-term opioid use—United States, 2006–2015.
Open accessAbstract
Because long-term opioid use often begins with treatment of acute pain (1), in March 2016, the CDC Guideline for Prescribing Opioids for Chronic Pain included recommendations for the duration of opioid therapy for acute pain and the type of opioid to select when therapy is initiated (2). However, data quantifying the transition from acute to chronic opioid use are lacking. Patient records from the IMS Lifelink+ database were analyzed to characterize the first episode of opioid use among commercially insured, opioid-naïve, cancer-free adults and quantify the increase in probability of long-term use of opioids with each additional day supplied, day of therapy, or incremental increase in cumulative dose. The largest increments in probability of continued use were observed after the fifth and thirty-first days on therapy; the second prescription; 700 morphine milligram equivalents cumulative dose; and first prescriptions with 10- and 30-day supplies. By providing quantitative evidence on risk for long-term use based on initial prescribing characteristics, these findings might inform opioid prescribing practices.
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The co-twin control design is susceptible to lower precision and bias from unmeasured within-family confounding and measurement error.
“The co-twin control design is susceptible to lower precision and bias from unmeasured within-family confounding and measurement error.”
From Association of opioid prescription initiation during adolescence and young adulthood with subsequent substance-related morbidity (2020) · cites this paper as [64]
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- Authors
- Shah, A., Hayes, C. J., & Martin, B. C.
- Affiliations
- Center for Surveillance, Epidemiology, and Laboratory Services (US)
- Corresponding author
- Shah, Anuj
- Venue
- MMWR Morbidity and Mortality Weekly Report
- Published
- 2017-03-17
- Volume
- 66
- Issue
- 10
- Pages
- 265-269
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC5657867
- OpenAlex
- W2596617588
- Cited by
- 954
- References
- 7
- Citations by year
- 2026: 31 · 2025: 64 · 2024: 59 · 2023: 84 · 2022: 111 · 2021: 132 · 2020: 153 · 2019: 155 · 2018: 121 · 2017: 38 · 2013: 1
- FWCI
- 119.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (T32DA022981)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- chronic opioid use, acute pain, chronic pain, opioid prescribing, morphine milligram equivalents, prescription duration, private insurance, opioid prescribing guidelines
- MeSH terms
- Adult, Analgesics, Opioid, Centers for Disease Control and Prevention, U.S., Female, Humans, Male, Middle Aged, Drug Prescriptions, Risk, Time Factors, United States, Practice Guidelines as Topic, Chronic Pain, Acute Pain
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