ArticlePain2014
National study of discontinuation of long-term opioid therapy among veterans.
Article in Pain, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of an Educational Pain Approach Before Elective Lower-extremity Surgery on 6-month Post-operative Use of Opioid Medication: A Randomized Clinical Trial
Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain
Feasibility of Near-infrared Spectroscopy to Measure Cortical Pain Pathway (Brain) Activation During Dry Needling
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Patient- and Clinician-Related Factors Associated With the Reduction in Opioid Use Among Adults With Chronic Non-Cancer Pain: A Systematic Review.Clinical pharmacology and therapeutics · 2026Pooled it
- Assessing the effectiveness of a narrative-based patient education video for promoting opioid tapering.Patient education and counseling · 2021Trial
- A randomized, pragmatic, pharmacist-led intervention reduced opioids following orthopedic surgery.The American journal of managed care · 2018Trial
- Factors associated with long-term opioid therapy discontinuation for people with chronic non-cancer pain in UK primary care: a population-based retrospective cohort study.British journal of anaesthesia · 2026Article
- Patterns of analgesic utilisation among people with knee osteoarthritis: a cohort study using UK primary care data.Journal of pharmaceutical policy and practice · 2025Article
- Article
- The contribution of nonmedical opioid use to healthcare encounters for opioid overdose and use disorders among long-term users with metastatic cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Impacts of social determinants of health on chronic opioid therapy for chronic non-cancer pain.Pain management · 2024Article
- External validation of a model to predict future chronic opioid use among hospitalized patients.Journal of hospital medicine · 2023Article
- Association between opioid therapy trajectories and potential opioid-related adverse health events.Pharmacoepidemiology and drug safety · 2022Article
- Opioid prescribing practices prior to elective foot and ankle surgery: a population-based evaluation using health administrative data from a tertiary hospital in Canada.BMC primary care · 2022Article
- Association between discontinuing chronic opioid therapy and newly diagnosed substance use disorders, accidents, self-inflicted injuries and drug overdoses within the prescribers' health care system: a retrospective cohort study.Addiction (Abingdon, England) · 2022Article
- Impact of transitioning from long-term to intermittent opioid therapy on the development of opioid-related adverse outcomes: A retrospective cohort study.Drug and alcohol dependence · 2022Article
- Association Between Pain Intensity and Discontinuing Opioid Therapy or Transitioning to Intermittent Opioid Therapy After Initial Long-Term Opioid Therapy: A Retrospective Cohort Study.The journal of pain · 2021Article
- Anxiety and Fear Avoidance Beliefs and Behavior May Be Significant Risk Factors for Chronic Opioid Analgesic Therapy Reliance for Patients with Chronic Pain-Results from a Preliminary Study.Pain medicine (Malden, Mass.) · 2021Article
- Effect of preoperative long-term opioid therapy on patient outcomes after total knee arthroplasty: an analysis of multicentre population-based administrative data.Canadian journal of surgery. Journal canadien de chirurgie · 2021Article
- Trajectories of Opioid Coverage After Long-Term Opioid Therapy Initiation Among a National Cohort of US Veterans.Journal of pain research · 2021Article
- The Association between Opioid Discontinuation and Heroin Use: A Nested Case-Control Study.Drug and alcohol dependence · 2020Article
- Medical Record Documentation About Opioid Tapering: Examining Benefit-to-Harm Framework and Patient Engagement.Pain medicine (Malden, Mass.) · 2020Article
- Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults.Population health management · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
Veterans have high rates of chronic pain and long-term opioid therapy (LTOT). Understanding predictors of discontinuation from LTOT will clarify the risks for prolonged opioid use and dependence among this population. All veterans with at least 90 days of opioid use within a 180-day period were identified using national Veteran's Health Affairs (VHA) data between 2009 and 2011. Discontinuation was defined as 6 months with no opioid prescriptions. We used Cox proportional hazards analysis to determine clinical and demographic correlates for discontinuation. A total of 550,616 veterans met criteria for LTOT. The sample was primarily male (93%) and white (74%), with a mean age of 57.8 years. The median daily morphine equivalent dose was 26 mg, and 7% received high-dose (>100mg MED) therapy. At 1 year after initiation, 7.5% (n=41,197) of the LTOT sample had discontinued opioids. Among those who discontinued (20%, n=108,601), the median time to discontinuation was 317 days. Factors significantly associated with discontinuation included both younger and older age, lower average dosage, and having received less than 90 days of opioids in the previous year. Although tobacco use disorders decreased the likelihood of discontinuation, co-morbid mental illness and substance use disorders increased the likelihood of discontinuation. LTOT is common in the VHA system and is marked by extended duration of use at relatively low daily doses with few discontinuation events. Opioid discontinuation is more likely in veterans with mental health and substance use disorders. Further research is needed to delineate causes and consequences of opioid discontinuation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.