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In this study, we examined the hypothesis that people with gout are more likely than individuals without gout to be prescribed long\u2010term opioids over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this matched cohort study using national Veterans Health Administration (VHA) data, multivariable Cox regression was used to examine the association of gout with long\u2010term opioid receipt (defined using a validated administrative algorithm). Patients with gout were identified using diagnostic codes and matched with up to 10 controls without gout by age, sex, and VHA enrollment year. In analyses limited to gout, factors associated with long\u2010term opioid exposure were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a mean follow\u2010up of 4.52 years, patients with gout were more likely to receive long\u2010term opioids than controls (6.9% vs 3.8%). This risk remained following covariate adjustment (adjusted hazard ratio 1.30; 95% confidence interval 1.28\u20131.32). Among patients with gout, factors independently associated with an increased likelihood of long\u2010term opioid exposure included more recent index year, younger age, female sex, non\u2010Hispanic Black race and ethnicity, rural residence, being underweight or obese, former or current smoking, greater comorbidity, urate\u2010lowering therapy receipt, and requirement of rheumatology consultation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with gout are more likely to receive long\u2010term opioids than counterparts without gout, independent of other factors. This risk is greater in underrepresented gout populations, those with greater comorbidity, patients requiring rheumatology consultations, and individuals prescribed urate\u2010lowering treatments. Additional investigation is needed to elucidate whether deployment of optimal gout management minimizes long\u2010term opioid exposure in patients with gout.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25622","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T10:35:14Z","timestamp":1754303714000},"page":"344-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Opioids in Gout: A Matched Cohort Study From the Veterans Health Administration"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-209X","authenticated-orcid":false,"given":"Lindsay N.","family":"Helget","sequence":"first","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"additional","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punyasha","family":"Roul","sequence":"additional","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harlan","family":"Sayles","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-1711","authenticated-orcid":false,"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"O'Dell","sequence":"additional","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz Veterans Affairs Medical Center and University of Pennsylvania  Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-2272","authenticated-orcid":false,"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21791"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24339"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40807"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.9501"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.3517"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21837"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23928"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280211032295"},{"key":"e_1_2_6_10_1","unstructured":"National Institute on Drug Abuse.Drug overdose deaths: facts and figures. 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