Evidence map›Paper›PMID 35128560›Full record

ArticlePediatrics2022

Initiation of Opioid Prescription and Risk of Suicidal Behavior Among Youth and Young Adults.

Kimberly L Fine, Martin E Rickert, Lauren M O'Reilly, Ayesha C Sujan, Katja Boersma, Zheng Chang, Johan Franck, Paul Lichtenstein, Henrik Larsson, Brian M D'Onofrio and 1 more

Open access · greenAbstract read
In one paragraph

Article in Pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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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

11 authors at 3 institutions in 2 countries.

Kimberly L FineDepartment of Applied Health Science, School of Public Health.
Martin E RickertDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
Lauren M O'ReillyDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
Ayesha C SujanDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
Katja BoersmaCenter for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work.
Zheng ChangDepartments of Medical Epidemiology and Biostatistics.
Johan FranckClinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Paul LichtensteinDepartments of Medical Epidemiology and Biostatistics.
Henrik LarssonSchool of Medical Sciences, Örebro University, Örebro, Sweden.
Brian M D'OnofrioDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
Patrick D QuinnDepartment of Applied Health Science, School of Public Health.
Indiana University Bloomington · USKarolinska Institutet · SEÖrebro University · SE

Funding

NRSA Training CoreTL1TR002531 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI FOTI, DANIEL JUSTIN, HURLEY, THOMAS D. · 2018 to 2022
$2.5M
Pharmacoepidemiologic Studies of Prescription Opioid Analgesic RisksR00DA040727 · NIDA · TRUSTEES OF INDIANA UNIVERSITY · PI QUINN, PATRICK DONOVAN · 2018 to 2020
$744k
Predicting Short-Term Risk for Suicidal Behavior after Contact with Outpatient Specialists: A Machine Learning ApproachF31MH121039 · NIMH · TRUSTEES OF INDIANA UNIVERSITY · PI O'REILLY, LAUREN MARIE · 2019 to 2021
$139k
NCATS NIH HHS TL1 TR002531NIDA NIH HHS R00 DA040727NIMH NIH HHS F31 MH121039
6 · The paper itself

Abstract

BACKGROUND AND

objectivesOpioids are involved in an increasing proportion of suicide deaths. This study examined the association between opioid analgesic prescription initiation and suicidal behavior among young people.

methodsWe analyzed Swedish population-register data on 1 895 984 individuals ages 9 to 29 years without prior recorded opioid prescriptions. We identified prescriptions dispensed from January 2007 onward and diagnosed self-injurious behavior and death by suicide through December 2013. We first compared initiators with demographically matched noninitiators. To account for confounding, we applied an active comparator design, which examined suicidal behavior among opioid initiators relative to prescription nonsteroidal antiinflammatory drug (NSAID) initiators while inverse-probability-of-treatment weighting with individual and familial covariates.

resultsAmong the cohort, 201 433 individuals initiated opioid prescription. Relative to demographically matched noninitiators, initiators (N = 180 808) had more than doubled risk of incident suicidal behavior (hazard ratio = 2.64; 95% confidence interval [CI], 2.47-2.81). However, in the active comparator design, opioid initiators (N = 86 635) had only 19% relatively greater risk of suicidal behavior compared with NSAID initiators (N = 255 096; hazard ratio = 1.19; 95% CI,: 1.11-1.28), corresponding to a weighted 5-year cumulative incidence of 2.2% (95% CI, 2.1-2.4) for opioid and 1.9% (95% CI, 1.9-2.0) for NSAID initiators. Most sensitivity analyses produced comparable results.

conclusionsOpioid initiation may make only a small contribution to the elevated risk of suicidal behavior among young people receiving pharmacologic pain management. In weighing benefits and harms of opioid initiation, our results suggest that increased risk of suicidal behavior may not be a major concern.

Indexed as

Analgesics, OpioidSuicidal IdeationAdolescentAdultAnti-Inflammatory Agents, Non-SteroidalChildHumansPainPrescriptionsYoung AdultAnalgesics, OpioidAnti-Inflammatory Agents, Non-Steroidal

Identifiers

PMID35128560
PMCPMC9624202
OpenAlexW4210851372

What OpenQuestion holds

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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.