{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:35:31Z","timestamp":1773725731347,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R36DA046717"],"award-info":[{"award-number":["R36DA046717"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We identified associations between membership in seven group\u2010based trajectories based on supply of filled opioid prescriptions and potential opioid\u2010related adverse health events over a 720\u2010day window.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified two veteran cohorts with chronic non\u2010cancer pain who initiated treatment with long\u2010term opioid therapy between 2008 and 2015, excluding those with prior substance use disorder (<jats:italic>n<\/jats:italic>\u00a0=\u00a0373\u2009941) or non\u2010SUD, opioid\u2010related adverse outcome (<jats:italic>n<\/jats:italic>\u00a0=\u00a0405\u2009631) diagnoses. Outcomes of interest included opioid use disorder, non\u2010opioid drug use disorder, and alcohol use disorder for the first cohort; or accidents resulting in wounds or injuries, self\u2010inflicted injuries, opioid\u2010related accidents and overdoses, alcohol and non\u2010opioid drug\u2010related accidents and overdoses, and violence\u2010related injuries for the second cohort. Using a cross\u2010sectional design, Veterans were followed until the specific outcome of interest was diagnosed, they died, the study ended, or they were lost to follow up. Accelerated failure time models were estimated for each outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Membership in persistent moderate days covered and persistent modest days covered trajectories was associated with decreased risk of opioid use disorder (Moderate: \u03b8\u00a0=\u00a00.59, 95%CI:0.54, 0.64; Modest: \u03b8\u00a0=\u00a00.54, 95%CI:0.50, 0.59) and opioid overdose (Moderate: \u03b8\u00a0=\u00a00.67,95%CI: 0.57, 0.79; Modest: \u03b8\u00a0=\u00a00.72, 95%CI:0.61, 0.85) versus higher\u2010utilizing persistent users. Rapid discontinuation was associated with decreased risk of opioid use disorder (\u03b8\u00a0=\u00a00.86, 95% CI:0.77, 0.95) and opioid overdose (\u03b8\u00a0=\u00a00.54, 95%CI:0.41, 0.71), but increased risk of alcohol use disorder (\u03b8\u00a0=\u00a01.07, 95%CI:1.00, 1.15) and other substance use disorders. Delayed discontinuation or delayed reduction was associated with increased risk for most opioid related adverse health events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Persistent use trajectories with low levels of opioid utilization were associated with lower risks of potential opioid\u2010related adverse health events.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5495","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T10:11:23Z","timestamp":1655115083000},"page":"1075-1090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between opioid therapy trajectories and potential opioid\u2010related adverse health events"],"prefix":"10.1002","volume":"31","author":[{"given":"Corey J.","family":"Hayes","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics, College of Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas USA"},{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4043-2583","authenticated-orcid":false,"given":"Ruston M.","family":"Koonce","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Elisabeth","family":"Gressler","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Hu","sequence":"additional","affiliation":[{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Silas","family":"Williams","sequence":"additional","affiliation":[{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-3098","authenticated-orcid":false,"given":"Bradley C.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences  Little Rock Arkansas 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