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Am J Surg. 2017 Nov;214(5):792-797. doi: 10.1016/j.amjsurg.2017.05.013. Epub 2017 Jun 7.

Patterns of use and factors associated with early discontinuation of opioids following major trauma.

Author information

1
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, MA, USA.
2
Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
3
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: ajschoenfeld@partners.org.

Abstract

BACKGROUND:

Inappropriate use of prescription opioids is a growing public-health issue. We sought to estimate the proportion of traumatic injury patients using legal prescription opioids up to 1-year after hospitalization.

METHODS:

We used 2006-2014 claims data from TRICARE insurance to identify adults hospitalized secondary to trauma between 2007 and 2013. Prescription opioid use was evaluated for one-year post-discharge. Risk-adjusted Cox Proportional-hazards models were used to evaluate predictors of opioid discontinuation.

RESULTS:

Only 1% of patients sustained legal prescription opioid use at 1-year following trauma. Lower socioeconomic status (HR 0.92, 95% CI 0.87-0.98) and higher injury severity (HR 0.88, 95% CI 0.84-0.91) were associated with sustained use. Younger patients (HR 1.12, 95% CI 1.04-1.21) and Black patients (HR 1.09, 95% CI 1.04-1.15) were found to have a higher likelihood of opioid discontinuation.

CONCLUSIONS:

In this population, adult patients who sustained trauma were not at high risk of sustained legal prescription opioid use.

KEYWORDS:

Opioid dependence; Sustained opioid use; Traumatic injury

PMID:
28619266
DOI:
10.1016/j.amjsurg.2017.05.013
[Indexed for MEDLINE]

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