ArticleJournal of the American College of Emergency Physicians open2021
Incidence of opioid use disorder in the year after discharge from an emergency department encounter.
Article in Journal of the American College of Emergency Physicians open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Development and Validation of the Decisions to use Opioids Measure.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2025Article
- Influences of Software Changes on Oxycodone Prescribing at an Australian Tertiary Emergency Department: A Retrospective Review.Pharmacy (Basel, Switzerland) · 2024Article
- Screening for problematic opioid use in the emergency department: Comparison of two screening measures.Journal of the American College of Emergency Physicians open · 2024Article
- Risk factors for the development of opioid use disorder after first opioid prescription: a Swedish national study.Psychological medicine · 2023Article
- Patient motivators to use opioids for acute pain after emergency care.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- Predicting at-risk opioid use three months after ed visit for trauma: Results from the AURORA study.PloS one · 2022Article
- Incidence of opioid use disorder in the year after discharge from an emergency department encounter.Journal of the American College of Emergency Physicians open · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTherapeutic opioid exposure is associated with long-term use. How much later use is due to opioid use disorder (OUD) and the incidence of OUD without preceding therapeutic exposure are unknown. We preliminarily explored the association between emergency department opioid prescriptions and subsequent OUD.
methodsThis retrospective cohort study queried electronic health records for discharged adult patients in the year before (2014) and after (2016) their first encounter in 2015 at either of 2 EDs in a Midwestern healthcare system. OUD was defined by diagnosis codes and prescription history. Patients with OUD history before the index encounter were excluded. We report OUD incidence within 1 year, with time to first indicator of OUD among those with a repeat health system encounter post index using a Cox proportional hazards model. Secondary outcomes were sources of therapeutic opioid exposure and frequency of risk factors associated with OUD among those who developed OUD.
resultsOf the 49,904 unique, adult ED patients without history of OUD, 669 (1.3%; 95% CI, 1.2-1.4) had health records indicating OUD within 12 months. The proportion of ED patients with OUD at 12 months was 1.5% (95% CI, 1.2-1.9) if prescribed an opioid at index and 1.3% (95% CI, 1.2-1.4) if not. Of the 669 who developed OUD, 80 (12.0%) were prescribed an opioid at the index ED visit, 54 (8%) received an opioid prescription at a subsequent ED visit, and median time to OUD was 4.5 months (interquartile range 1.6-7.6, range 0.0-11.9). When controlling for demographics, mental health, and prior opioid prescriptions, there was no difference in OUD incidence between patients who did or did not receive an initial ED opioid prescription (HR, 1.1; 95% CI, 0.9-1.4).
conclusionsA small but meaningful proportion of the ED population will develop OUD within 1 year even without ED opioid prescription. Though we found no association between ED opioid prescription and later OUD, further study is warranted given the complexity factors influencing OUD incidence, ongoing ED opioid exposure, and limitations inherent to this study design.
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