Evidence map›Paper›PMID 32428788›Full record

ArticleDrug and alcohol dependence2020

Opioid prescribing history prior to heroin overdose among commercially insured adults.

Pooja Lagisetty, Kun Zhang, Rebecca L Haffajee, Lewei Allison Lin, Jason Goldstick, Rebecca Brownlee, Amy Bohnert, Marc R Larochelle

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022
    Guideline
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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

8 authors at 4 institutions in 1 country.

Pooja LagisettyDepartment of Internal Medicine, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA; Center for Clinical Management and Research, Ann Arbor VA Hospital, 2215 Fuller Road, MS 152, Ann Arbor, MI 48105, USA. Electronic address: lagiset@med.umich.edu.
Kun ZhangDivision of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway, MS F62, Atlanta, GA 30341, USA.
Rebecca L HaffajeeDepartment of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; RAND Corporation.
Lewei Allison LinCenter for Clinical Management and Research, Ann Arbor VA Hospital, 2215 Fuller Road, MS 152, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
Jason GoldstickInjury Prevention Center, University of Michigan, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
Rebecca BrownleeDepartment of Psychiatry, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
Amy BohnertCenter for Clinical Management and Research, Ann Arbor VA Hospital, 2215 Fuller Road, MS 152, Ann Arbor, MI 48105, USA; Department of Anesthesiology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
Marc R LarochelleClinical Addiction Research and Education Unit at Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Ave., 2nd Floor, Boston, MA 02118, USA.
University of Michigan · USBoston University · USNational Center for Injury Prevention and Control · USRAND Corporation · US

Funding

A Tailored Behavioral Intervention To Increase Engagement in Opioid Tapering in Primary Care SettingsK23DA047475 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LAGISETTY, POOJA · 2019 to 2023
$970k
Improving urine drug test utility to mitigate prescription opioid riskK23DA042168 · NIDA · BOSTON MEDICAL CENTER · PI LAROCHELLE, MARC · 2017 to 2021
$956k
Heroin use and overdose following changes to individual-level opioid prescribingU01CE002780 · CE · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BOHNERT, AMY S B, LAROCHELLE, MARC · 2017 to 2018
$800k
EPA EP-C-18-008NCIPC CDC HHS U01 CE002780NIDA NIH HHS K23 DA042168NIDA NIH HHS K23 DA047475
6 · The paper itself

Abstract

backgroundSince 2010, heroin-related overdoses have risen sharply, coinciding with policies to restrict access to prescription opioids. It is unknown if patients tapered or discontinued off prescription opioids transitioned to riskier heroin use. This study examined opioid prescribing, including long-term opioid therapy (LTOT) and discontinuation, prior to heroin overdose.

methodsWe used retrospective longitudinal data from a national claims database to identify adults with an emergency or inpatient claim for heroin overdose between January 2010 and June 2017. Receipt of opioid prescription, LTOT episodes, and discontinuation of LTOT were measured for the period of one year prior to heroin overdose.

resultsWe identified 3183 individuals (53.2% age 18-25; 70.0% male) with a heroin overdose (incidence rate 4.20 per 100k person years). Nearly half (42.3%) received an opioid prescription in the prior 12 months, and 10.9% had an active opioid prescription in the week prior to overdose. LTOT at any time in the 12 months prior to overdose was uncommon (12.8%) among those with heroin overdoses, especially among individuals 18-25 years old (3.5%, P < 0.001). LTOT discontinuation prior to overdose was also relatively uncommon, experienced by 6.7% of individuals aged 46 and over and 2.5% of individuals aged 18-25 years (P < 0.001).

conclusionsPrior to heroin overdose, prescription opioid use was common, but LTOT discontinuation was uncommon and observed primarily in older individuals with the lowest heroin overdose rates. Further study is needed to determine if these prescribing patterns are associated with increased heroin overdose.

Indexed as

Drug PrescriptionsAdolescentAdultAgedAnalgesics, OpioidDatabases, FactualDrug OverdoseEmergency Service, HospitalFemaleHeroinHumansInsurance Claim ReviewInsurance, HealthLongitudinal StudiesMaleMiddle AgedAnalgesics, OpioidHeroinDiscontinuationHeroinOpioidOverdosePrescriptionTaper

Identifiers

PMID32428788
PMCPMC7768819
OpenAlexW3024049048

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.