Evidence map›Paper›PMID 29340270›Full record

ArticlePreventive medicine reports2018

Outpatient, combined use of opioid and benzodiazepine medications in the United States, 1993-2014.

Matthew E Hirschtritt, Kevin L Delucchi, Mark Olfson

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Preventive medicine reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03549611 (Randomized Comparison of Two Pre-induction Analgesia Regimens), which is not on this map. Cited by 39 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03549611 phase4withdrawnnot on this map

Randomized Comparison of Two Pre-induction Analgesia Regimens: Multimodal vs Acetaminophen in the Reduction of Post-operative Pain Following Ureteroscopy With Lithotripsy for Kidney Stones Evaluated With Text Messaging

TypeinterventionalSponsorKevin J Flynn MDRan2018 to 2019Enrolled0ConditionsKidney Calculi, Pain, PostoperativeArmsMultimodal Oral Drug Regimen, Acetaminophen
3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  19. A Novel Maintenance Therapeutic for Opioid Use Disorder.The Journal of pharmacology and experimental therapeutics · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Matthew E HirschtrittDepartment of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Box 0984-RTP, San Francisco, CA 94143, United States.
Kevin L DelucchiDepartment of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Box 0984, San Francisco, CA 94143, United States.
Mark OlfsonDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The combined use of opioid and benzodiazepine medications increases the risk of hazardous effects, such as respiratory depression. Although recent increases in outpatient use of opioid prescriptions have been documented, there are limited data regarding rates and correlates of combined opioid and benzodiazepines among adults in outpatient settings. Our objective was to examine annual trends in outpatient visits including opioids, benzodiazepines, and their combination among adults as well as clinical and demographic correlates. We used data from the 1993-2014 National Ambulatory Medical Care Survey (NAMCS) among non-elderly (i.e., ages 18-64 years) adults to examine the probability of a visit including an opioid, benzodiazepine, or their combination, in addition to clinical and demographic correlates. From 1993 to 2014, benzodiazepines-with-opioids visits increased from 9.8 to 62.5 (OR = 9.23, 95% CI = 5.45-15.65) per 10,000 visits. Highest-represented groups among benzodiazepines-with-opioids visits were older (50-64 years) (49.1%), white (88.8%), commercially insured (58.0%) patients during their first visit (87.6%) to a primary-care physician (41.9%). We identified a significant increase in the outpatient co-prescription of opioids and benzodiazepines, notably among adults aged 50-64 years during primary-care visits. Educational and policy changes to provide alternatives to benzodiazepine-with-opioid co-prescription and limiting opioid prescription to pain specialists may reduce rates of this potentially hazardous combination.

Indexed as

BenzodiazepineCDC, Centers for Disease Control and PreventionCI, confidence intervalICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical ModificationMedication safetyNAMCS, National Ambulatory Medical Care SurveyNCHS, National Center for Health StatisticsOpioidOR, odds ratioPainPrescriptionsRFV, reason-for-visit

Identifiers

PMID29340270
PMCPMC5766756

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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.