ArticleAddiction (Abingdon, England)2021
Opioid use disorder and overdose among youth following an initial opioid prescription.
Article in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis 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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use, Update 2018-2023: Current Status, Best Practices, and Opportunities for Advancing the Science.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53Pooled it
- Implementation and Effectiveness of an Enhanced Recovery Protocol for Children Undergoing Surgery: The ENRICH-US Stepped-Wedge Cluster-Randomized Trial.JAMA surgery · 2026Trial
- Genetic variation in BDNF is associated with opioid use disorder severity.Human genetics · 2026Article
- Gabapentin and Opioid Prescribing Trends among Adolescents Undergoing Common Procedures: A National Retrospective Cohort Study.Anesthesiology · 2026Article
- Adolescent outcomes of Post-operative opioid EXposure (APEX): Protocol for a multisite observational study.Journal of substance use and addiction treatment · 2026Article
- The Adolescent Surgery Experience (ASE): a survey-based prospective cohort study to measure risk factors for persistent opioid use.BJA open · 2025Article
- Association Between Congenital Heart Disease Complexity, Mental Health Conditions and Opioid Use Disorder.JACC. Advances · 2025Article
- Balancing Relief and Risk: The Potential Impact of Pediatric Opioid Prescriptions on Family Members.The Journal of pediatrics · 2025Article
- Product and trial design considerations on the path towards a vaccine to combat opioid overdose.NPJ vaccines · 2025Review
- Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths.JAMA network open · 2024Article
- Is age of onset and duration of stimulant therapy for ADHD associated with cocaine, methamphetamine, and prescription stimulant misuse?Journal of child psychology and psychiatry, and allied disciplines · 2024Article
- Review of Opioid Abuse-Deterrent Formulations: Impact and Barriers to Access.Journal of pain research · 2024Review
- Association of a State Prescribing Limits Policy with Opioid Prescribing and Long-term Use: an Interrupted Time Series Analysis.Journal of general internal medicine · 2023Article
- Gut microbiota alterations may increase the risk of prescription opioid use, but not vice versa: A two-sample bi-directional Mendelian randomization study.Frontiers in microbiology · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsSome adolescents and young adults (termed "youth") prescribed an opioid will develop opioid use disorder or experience overdose. This study aimed to identify patient and prescription characteristics associated with subsequent risk of opioid use disorder or overdose during the year after an opioid is first dispensed.
designRetrospective cohort study.
settingCommercial health insurance claims in a large United States (US) database from 2006 to 2016.
participantsYouth age 11 to 25 years filling an initial opioid prescription (n = 3 278 990). MEASUREMENTS: The primary outcome was development of an 'opioid-related complication' (a diagnosis of opioid use disorder or opioid-related overdose) during the subsequent 12 months. Exposures of interest were patient (sociodemographic information, and physical and mental health diagnoses) and prescription characteristics (opioid formulation, dose, and duration).
findingsAmong youth filling an initial opioid prescription, median age was 18 years (interquartile range [IQR] = 16-21) and 56.1% were female. During the subsequent 12 months, 10 405 (0.3%) youth experienced an opioid-related complication. Conditions associated with increased risk included mood/anxiety disorders (adjusted relative risk [aRR] = 4.45; 95% CI = 4.25-4.66) and substance use (aRR = 20.77; 95% CI = 19.74-21.84). Comorbid substance use disorders were present among 72.8% of youth experiencing an opioid-related complication and included alcohol (33.4%), cannabis (33.0%), nicotine (43.2%), and other substance use disorders (75.5%). Long-acting opioids (aRR = 2.59; 95% CI = 2.18-3.09) and longer durations were associated with increased risk (7-14 days: aRR = 1.15; 95% CI = 1.08-1.22; ≥15 days: aRR = 1.96; 95% CI = 1.80-2.12) compared with short-acting formulations and durations ≤3 days, respectively.
conclusionsAmong United States youth, complications after an initial opioid prescription appear to be relatively rare and appear to be associated with mood/anxiety disorders, substance use, comorbid substance use disorders, and prescriptions involving long-acting opioids or long durations.
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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.