ArticleAnnals of emergency medicine2019
Conversion to Persistent or High-Risk Opioid Use After a New Prescription From the Emergency Department: Evidence From Washington Medicaid Beneficiaries.
Article in Annals of emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04717518 (Anchoring Patients Pain Scores in the Emergency Department), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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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.
Anchoring Patients Pain Scores in the Emergency Department
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Advances in prescription drug monitoring program research: a literature synthesis (June 2018 to December 2019).Current opinion in psychiatry · 2020Pooled it
- A Multicentered Randomized Controlled Trial Comparing the Effectiveness of Pain Treatment Communication Tools in Emergency Department Patients With Back or Kidney Stone Pain.American journal of public health · 2022Trial
- Effect of an Electronic Health Record "Nudge" on Opioid Prescribing and Electronic Health Record Keystrokes in Ambulatory Care.Journal of general internal medicine · 2021Trial
- Association of acute opioid-induced euphoria and analgesia with subsequent opioid prescriptions in an emergency department-based prospective cohort study.Clinical and experimental emergency medicine · 2026Article
- A Prospective Cohort Study to Determine Which Opioid-Naïve Emergency Department Patients Are at Risk of Persistent Opioid Use.Annals of emergency medicine · 2025Article
- Opioid Prescribing Patterns and Characteristics of Hand Injury Presentations to the Emergency Department of a Surgical Referral Centre in Western Sydney.Emergency medicine Australasia : EMA · 2025Article
- Adolescents' and Parents' Perspectives on Using the MedSMARxT Families Intervention in Emergency Departments for Opioid Medication Safety Education: Mixed Methods Study.JMIR serious games · 2025Article
- Effect of emergency department opioid prescribing on health outcomes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Outcomes of an Emergency Department opioid alternatives Program implemented within a safety-net hospital system.BMC emergency medicine · 2025Article
- The burden of acute pain in the U.S. in the wake of the opioid crisis.Frontiers in pain research (Lausanne, Switzerland) · 2025Review
- Limited use of opioid prescribing guidelines in Dutch emergency departments: results of a nationwide survey.International journal of emergency medicine · 2024Article
- Association of Race and Ethnicity With Postoperative Gabapentinoid and Opioid Prescribing Trends for Older Adults.The Journal of surgical research · 2024Article
- Opioid therapy trajectories of patients with chronic non-cancer pain over 1 year of follow-up after initiation of short-acting opioid formulations.Pain medicine (Malden, Mass.) · 2024Article
- Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Postoperative Opioid Prescribing and New Persistent Opioid Use: The Risk of Excessive Prescribing.Annals of surgery · 2023Article
- Variation in prescribing of opioids for emergency department encounters: A cohort study in the Military Health System.Journal of evaluation in clinical practice · 2022Article
- Patterns of opioid prescribing in emergency departments during the early phase of the COVID-19 pandemic.The American journal of emergency medicine · 2022Article
- Managing Acute Pain With Opioids in the Emergency Department: A Teachable Moment?American journal of public health · 2022Article
- Prescription quantity and duration predict progression from acute to chronic opioid use in opioid-naïve Medicaid patients.PLOS digital health · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
STUDY
objectiveWe describe the overall risk and factors associated with transitioning to persistent opioid or high-risk use after an initial emergency department (ED) opioid prescription.
methodsA retrospective cohort study of Washington Medicaid beneficiaries was performed with linked Medicaid and prescription drug monitoring program files. We identified adults who had no record of opioid prescriptions in the previous 12 months, and who filled a new opioid prescription within 1 day of an ED discharge in 2014. We assessed the risk of persistent opioid use or high-risk prescription fills within 12 months after the index visit. Logistic regression was used to assess the association between pertinent variables and conversion to persistent or high-risk use.
resultsAmong 202,807 index ED visits, 23,381 resulted in a new opioid prescription. Of these, 13.7% led to persistent or high-risk opioid prescription fills within 12 months compared with 3.2% for patients who received no opioids at the index visit. Factors associated with increased likelihood of persistent opioid or high-risk prescription fills included a history of skeletal or connective-tissue disorder; neck, back, or dental pain; and a history of prescribed benzodiazepines. The highest conversion rates (37.3%) were observed among visits in which greater than or equal to 350 morphine milligram equivalents were prescribed. Conversion rates remained greater than 10% even among visits resulting in lower-dose opioid prescriptions.
conclusionMedicaid recipients are at moderate risk for conversion to persistent or high-risk opioid use after a new ED prescription. Longer or higher-dose prescriptions are associated with increased risk for conversion; however, even visits that lead to guideline-concordant prescriptions bear some risk for long-term or high-risk use.
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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.