{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T03:05:58Z","timestamp":1785639958107,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To measure incidence rates of and risk factors for opioid overdose among new users of prescription opioids in the Medicaid population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort study using Medicaid claims from four states (1999\u20102012) among adults continuously enrolled in Medicaid for \u22653\u2009years free of opioid prescriptions and opioid overdose before cohort entry. Exposure and outcome of interest were prescription opioid use and apparent incident opioid overdose identified in inpatient and outpatient claims (sensitivity\u2009\u2248\u200997%; positive predictive value\u2009\u2248\u200987%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among new prescription opioid users (1\u2009336\u2009140 persons; 246\u2009466 person\u2010years), the overall opioid overdose incidence rate per 100\u2009000 person\u2010years was 247.1 (95% confidence interval [CI], 227.5\u2010266.7), with 251.0 (CI, 188.6\u2010313.5) in 2002 and 225.5 (CI, 142.0\u2010309.0) in 2012. A lower hazard for opioid overdose was seen for age 65\u201080\u2009years (adjusted hazard ratio [HR], 0.50; CI, 0.37\u20100.66) and 80\u2010100\u2009years (0.35; 0.23\u20100.52) vs 18\u201035\u2009years; females (0.79; 0.67\u20100.93) vs males; and other\/unknown race\/ethnicity (0.71; 0.54\u20100.93) vs whites. A higher hazard was seen for initial opioid dose in morphine milligram equivalents (MMEs), 50\u2010100\u2009MME\/day (1.52; 1.24\u20101.86) and &gt;100\u2009MME\/day (1.98; 1.55\u20102.53), vs &lt;50\u2009MME\/day; prior diagnosis of substance use disorders (2.30; 1.91\u20102.79) or mental health conditions (1.75; 1.47\u20102.08); and prior prescriptions for benzodiazepines (1.43; 1.13\u20101.81).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In Medicaid enrollees in four study states during 2002 to 2012, opioid overdose incidence rate per 100\u2009000 person\u2010years among apparent new users of prescription opioids was 247.1, with 251.0 in 2002 and 225.5 in 2012. Younger ages, white race\/ethnicity, higher MME opioid daily doses, prior substance use disorders, mental health conditions, and benzodiazepine prescriptions were associated with a higher risk of opioid overdose incidence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5067","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T09:13:56Z","timestamp":1594372436000},"page":"931-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Incidence rates of and risk factors for opioid overdose in new users of prescription opioids among <scp>US<\/scp> Medicaid enrollees: A cohort study"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-0821","authenticated-orcid":false,"given":"Young Hee","family":"Nam","sequence":"first","affiliation":[{"name":"Department of Population Medicine Harvard Medical School, Harvard Pilgrim Health Care Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, Perelman of School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco J.","family":"DeMayo","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"School of Dental medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Neuman","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Critical Care, Perelman of School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Hennessy","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, Perelman of School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"National Institute on Drug Abuse.Overdose Death Rates. Accessed August 1 2019.https:\/\/www.drugabuse.gov\/related-topics\/trends-statistics\/overdose-death-rates. 2019."},{"key":"e_1_2_12_3_1","volume-title":"Why do adults misuse prescription drugs? The CBHSQ Report: July 27","author":"Lipari RN","year":"2017"},{"key":"e_1_2_12_4_1","unstructured":"The Council of Economic Advisers (CEA).The underestimated Cost of the Opioid Crisis. Accessed August 1 2019.https:\/\/www.whitehouse.gov\/sites\/whitehouse.gov\/files\/images\/The%20Underestimated%20Cost%20of%20the%20Opioid%20Crisis.pdf. 2017."},{"issue":"42","key":"e_1_2_12_5_1","first-page":"1171","article-title":"Overdose deaths involving prescription opioids among Medicaid enrollees \u2013 Washington, 2004\u20102007","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"issue":"13","key":"e_1_2_12_7_1","first-page":"S243","article-title":"The economic burden of the opioid epidemic on states: the case of Medicaid","volume":"25","author":"Leslie DL","year":"2019","journal-title":"Am J Manag Care."},{"key":"e_1_2_12_8_1","unstructured":"Kaiser Family Foundation.State health facts: Health insurance coverage of the total population. Accessed August 1 2019.https:\/\/www.kff.org\/other\/state\u2010indicator\/total\u2010population\/?dataView=1&currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22 %22sort%22:%22asc%22%7D. 2017."},{"key":"e_1_2_12_9_1","unstructured":"US Department of Commerce.National Technical Information Service. Federal Data Products \u2013 Death Master File (Limited Access DMF). Accessed September 30 2018.https:\/\/www.ntis.gov\/federal-data-products.html."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000738"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0038"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0054496"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f174"},{"key":"e_1_2_12_14_1","volume-title":"Consensus Recommendations for National and State Poisoning Surveillance","author":"Injury Surveillance Workgroup 7","year":"2012"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4772"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4157"},{"key":"e_1_2_12_17_1","volume-title":"CDC compilation of benzodiazepines, muscle relaxants, stimulants, zolpidem, and opioid analgesics with oral morphine milligram equivalent conversion factors, 2017 version","author":"National Center for Injury Prevention and Control","year":"2017"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.370"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-2-201001190-00006"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000245"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.02.014"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j760"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.06.004"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0919"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12711"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.9740\/mhc.2017.11.276"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpds.5067","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.5067","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.5067","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.5067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:33:01Z","timestamp":1693960381000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.5067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,10]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1002\/pds.5067"],"URL":"https:\/\/doi.org\/10.1002\/pds.5067","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,10]]},"assertion":[{"value":"2019-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}