Evidence map›Paper›PMID 41967810›Full record

ArticleJournal of substance use and addiction treatment2026

Adolescent outcomes of Post-operative opioid EXposure (APEX): Protocol for a multisite observational study.

Sharon Levy, Sydney Pierce, Joseph Cravero, Sabeeh A Baig, Melissa Brogna, Vidya Chidambaran, Tessa Mandler, Tori Sutherland, Allison Fernandez, Gabriel Brat and 9 more

Abstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

Sharon LevyDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America; Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America. Electronic address: Sharon.levy@childrens.harvard.edu.
Sydney PierceDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Joseph CraveroDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States of America; Department of Anaesthesia, Harvard Medical School, Boston, MA, United States of America.
Sabeeh A BaigNational Institute of Drug Abuse, Bethesda, MD, United States of America.
Melissa BrognaDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Vidya ChidambaranDepartment of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; Department of Anesthesia, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America.
Tessa MandlerAnesthesiology Department, Children's Hospital Colorado, Aurora, CO, United States of America; Department of Anesthesiology-Pediatric Anesthesiology, University of Colorado Anschutz Medical Campus, United States of America.
Tori SutherlandDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, United States of America.
Allison FernandezDepartment of Anesthesia, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States of America; Department of Clinical Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Gabriel BratDepartment of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States of America.
Denis AgnielRAND Corporation, Santa Monica, CA, United States of America.
Gabriel HasslerRAND Corporation, Santa Monica, CA, United States of America.
Machiko MinegishiDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Charlotte WalterDepartment of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; Department of Anesthesia, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America.
Griffin WeberDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.
Dinah Sher GongoraDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Rose WosepkaDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Elissa R WeitzmanDivision of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States of America; Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America.
Geetha A SubramaniamNational Institute of Drug Abuse, Bethesda, MD, United States of America.

Funding

The National Drug Abuse Treatment Clinical Trials NetworkUG1DA015831 · NIDA · YALE UNIVERSITY · PI Gail D'Onofrio, Roger D. Weiss · 2015 to 2026
$110.8M
NIDA NIH HHS UG1 DA015831
6 · The paper itself

Abstract

introductionAdolescents accounted for 5% of fatal overdoses in the United States in 2023 (Centers for Disease Control and Prevention, 2024), yet existing research on the risk factors for non-medical opioid use (not prescribed, more frequent, or in a greater quantity than intended) among adolescent patients remains limited. Surgical procedures serve as a first exposure to opioids for many adolescents and may lead to an increased likelihood of non-medical opioid use or future opioid use disorder (OUD). Although the prevalence of OUD in adolescents ages 12-17 is low-1.2% (Center for Behavioral Health Statistics S, 2024)-- identifying risk of opioid use disorder (ROUD) in adolescence could present an opportunity to intervene and support vulnerable individuals. Preventive interventions for adolescents undergoing surgical procedures could interrupt the trajectory from non-medical use to OUD, minimizing negative health effects and reducing the risk for fatal overdose.

methodsUsing a biopsychosocial model of the development of OUD, the Adolescent outcomes of Post-operative opioid EXposure (APEX) study gathers medical record and survey data from adolescent-parent dyads to better understand the relationship between pain, pain management, prescription opioid use and recovery from surgical procedures.

resultsIn this paper, we describe objectives and design of the APEX study, which aims to develop and validate systematic tools that are designed to detect ROUD in adolescent surgical patients in the 12 months following surgery.

conclusionsResults of this study could provide insight into predictors of ROUD, which may inform prescribing practices in the future, help update protocols for managing pain in young people and guide future research efforts.

Indexed as

Non-medical opioid useOpioid use disorderPediatricPrescription opioidsProlonged pain

Identifiers

PMID41967810
PMCPMC13132467

What OpenQuestion holds

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Registered trials

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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.