{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:52:21Z","timestamp":1787003541864,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["HU00012120089"],"award-info":[{"award-number":["HU00012120089"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Over the last decade, various efforts have been made to curtail the opioid crisis. The impact of these efforts, since the onset of the COVID-19 pandemic, has not been well characterized. We sought to develop national estimates of the prevalence of sustained prescription opioid use for a time period spanning the COVID-19 pandemic (2017\u20132021). We used TRICARE claims data (fiscal year 2017\u20132021) to identify patients who were prescription opioid non-users prior to receipt of a new opioid medication. We evaluated eligible patients for subsequent sustained prescription opioid use. The prevalence of sustained prescription opioid use during 2020\u20132021 was compared to 2017\u20132019. We performed multivariable logistic regression analyses to adjust for confounding. We performed secondary analyses that accounted for interactions between the time period and age, as well as a proxy for socioeconomic status. We determined there was a 68% reduction in the odds of sustained prescription opioid use (OR 0.32; 95% CI 0.27, 0.38;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) in 2020\u20132021 as compared to 2017\u20132019. Significant reductions were identified across all US census divisions and all patient age groups. In both time periods, the plurality of encounters associated with initial receipt of an opioid that culminated in sustained prescription opioid use were associated with non-specific primary diagnoses. We found significant reductions in sustained prescription opioid use in 2020\u20132021 as compared to 2017\u20132019. The persistence of prescribing behaviors that result in issue of opioids for poorly characterized conditions remains an area of concern.\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-52032-4","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T15:02:17Z","timestamp":1705417337000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Reductions in sustained prescription opioid use within the US between 2017 and 2021"],"prefix":"10.1038","volume":"14","author":[{"given":"Andrew J.","family":"Schoenfeld","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Munigala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman J.","family":"Schoenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Banaag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Coles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey P.","family":"Koehlmoos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"52032_CR1","unstructured":"Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https:\/\/www.samhsa.gov\/data\/ Accessed August 23, 2023."},{"issue":"15","key":"52032_CR2","first-page":"541","volume":"70","author":"F Luo","year":"2021","unstructured":"Luo, F., Li, M. & Florence, C. State level economic costs of opioid use disorder and fatal opioid overdose\u2014United States, 2017. MMWR 70(15), 541\u2013546 (2021).","journal-title":"MMWR"},{"key":"52032_CR3","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36687","volume":"4","author":"B Lee","year":"2021","unstructured":"Lee, B., Zhao, W., Yang, K. C., Ahn, Y. Y. & Perry, B. L. Systematic evaluation of state policy interventions targeting the US opioid epidemic, 2007\u20132018. JAMA Netw. Open 4, e2036687 (2021).","journal-title":"JAMA Netw. Open"},{"issue":"4","key":"52032_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.6147","volume":"4","author":"JM Currie","year":"2021","unstructured":"Currie, J. M., Schnell, M. K., Schwandt, H. & Zhang, J. Prescribing of opioid analgesics and buprenorphine for opioid use disorder during the COVID-19 pandemic. JAMA Netw. Open 4(4), e216147 (2021).","journal-title":"JAMA Netw. Open"},{"key":"52032_CR5","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1007\/s11524-022-00610-0","volume":"99","author":"R Ghose","year":"2022","unstructured":"Ghose, R., Forati, A. M. & Mantsch, J. R. Impact of the COVID-19 pandemic on opioid overdose death: A spatiotemporal analysis. J. Urban Health 99, 316\u2013327 (2022).","journal-title":"J. Urban Health"},{"key":"52032_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2023-104430","author":"JA Durant","year":"2023","unstructured":"Durant, J. A., Rettaliata, G. C., Bryan, A. C., Taenzer, A. H. & Abess, A. Years of potential life lost from COVID-19 and the opioid crisis in 2020\u20132021 in Northern New England. Reg. Anesth. Pain Med. https:\/\/doi.org\/10.1136\/rapm-2023-104430 (2023).","journal-title":"Reg. Anesth. Pain Med."},{"key":"52032_CR7","doi-asserted-by":"publisher","first-page":"e2397","DOI":"10.1093\/milmed\/usac391","volume":"188","author":"AM Crawford","year":"2023","unstructured":"Crawford, A. M. et al. Changes in elective and urgent surgery among TRICARE beneficiaries during the COVID-19 pandemic. Mil. Med. 188, e2397\u2013e2404 (2023).","journal-title":"Mil. Med."},{"key":"52032_CR8","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1001\/jamasurg.2018.0480","volume":"153","author":"AJ Schoenfeld","year":"2018","unstructured":"Schoenfeld, A. J., Kaji, A. H. & Haider, A. H. Practical guide to surgical data sets: Military Health System TRICARE encounter data. JAMA Surg. 153, 679\u2013680 (2018).","journal-title":"JAMA Surg."},{"key":"52032_CR9","unstructured":"Crawford, A. M., Striano, B. M., Gong, J., Koehlmoos, T. P., Simpson, A. K. & Schoenfeld, A. J.\u00a0Validation of the stopping opioids after surgery (SOS) score for sustained postoperative opioid use in orthopaedic surgery patients. J. Bone Jt. Surg. Am. 2023 (Accepted for publication 6\/12\/23)."},{"key":"52032_CR10","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1001\/jamasurg.2017.3132","volume":"153","author":"RE Scully","year":"2018","unstructured":"Scully, R. E. et al. Defining optimal length of opioid pain medication prescription after common surgical procedures. JAMA Surg. 153, 37\u201343 (2018).","journal-title":"JAMA Surg."},{"key":"52032_CR11","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1097\/MLR.0b013e3181e35be8","volume":"48","author":"RW Gimbel","year":"2010","unstructured":"Gimbel, R. W., Pangaro, L. & Barbour, G. America\u2019s \u201cundiscovered\u201d laboratory for health services research. Med. Care 48, 751\u2013756 (2010).","journal-title":"Med. Care"},{"issue":"4","key":"52032_CR12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.6438","volume":"6","author":"SR Steuart","year":"2023","unstructured":"Steuart, S. R., Lawler, E. C., Adams, G. B., Shone, H. & Abraham, A. J. Comparison of postpartum opioid prescriptions before versus during the COVID-19 pandemic. JAMA Netw. Open 6(4), e236438 (2023).","journal-title":"JAMA Netw. Open"},{"issue":"11","key":"52032_CR13","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1056\/NEJMsa1807069","volume":"380","author":"W Zhu","year":"2019","unstructured":"Zhu, W., Chernew, M. E., Sherry, T. B. & Maestas, N. Initial opioid prescriptions among U.S. Commercially insured patients, 2012\u20132017. N. Engl. J. Med. 380(11), 1043\u20131052 (2019).","journal-title":"N. Engl. J. Med."},{"key":"52032_CR14","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1001\/jamasurg.2017.2628","volume":"152","author":"AJ Schoenfeld","year":"2017","unstructured":"Schoenfeld, A. J. et al. Sustained prescription opioid use among previously opioid-naive patients insured through TRICARE (2006\u20132014). JAMA Surg. 152, 1175\u20131176 (2017).","journal-title":"JAMA Surg."},{"issue":"6","key":"52032_CR15","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1016\/j.spinee.2018.12.014","volume":"19","author":"ER Oleisky","year":"2019","unstructured":"Oleisky, E. R. et al. Comparing different chronic preoperative opioid use definitions on outcomes after spine surgery. Spine J. 19(6), 984\u2013994 (2019).","journal-title":"Spine J."},{"issue":"5","key":"52032_CR16","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1016\/j.jvs.2013.05.008","volume":"58","author":"AJ Henry","year":"2013","unstructured":"Henry, A. J., Hevelone, N. D., Lipsitz, S. & Nguyen, L. L. Comparative methods for handling missing data in large databases. J. Vasc. Surg. 58(5), 1353-1359.e6 (2013).","journal-title":"J. Vasc. Surg."},{"issue":"1","key":"52032_CR17","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1080\/08897077.2022.2060450","volume":"43","author":"JL Brown","year":"2022","unstructured":"Brown, J. L., Cochran, G., Bryan, M. A., Charron, E. & Winhusen, T. J. Associations between elevated depressive symptoms and substance use, prescription opioid misuse, overdose history, pain, and general health among community pharmacy patients prescribed opioids. Subst. Abus. 43(1), 1110\u20131115 (2022).","journal-title":"Subst. Abus."},{"issue":"10","key":"52032_CR18","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1080\/13696998.2019.1645680","volume":"22","author":"MA Yenikomshian","year":"2019","unstructured":"Yenikomshian, M. A. et al. Modeling the potential impact of abuse-deterrent opioids on medical resource utilization. J. Med. Econ. 22(10), 1073\u20131079 (2019).","journal-title":"J. Med. Econ."},{"issue":"2","key":"52032_CR19","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1007\/s11414-022-09820-5","volume":"50","author":"CA Betancourt","year":"2023","unstructured":"Betancourt, C. A., Kitsantes, P., Goldberg, D. G. & Hawks, B. A. Prescription opioid misuse and suicidal behaviors among US veterans: A cross-sectional study from the 2015\u20132019 national survey on drug use and health. J. Behav. Health Serv. Res. 50(2), 150\u2013164 (2023).","journal-title":"J. Behav. Health Serv. Res."},{"key":"52032_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.209028","volume":"149","author":"A Kline","year":"2023","unstructured":"Kline, A. et al. Predictors of opioid overdose during the COVID-19 pandemic: The role of relapse, treatment access and nonprescribed buprenorphine\/naloxone. J. Subst. Use Addict. Treat 149, 209028 (2023).","journal-title":"J. Subst. Use Addict. Treat"},{"issue":"6","key":"52032_CR21","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.1574","volume":"4","author":"SR Lindner","year":"2023","unstructured":"Lindner, S. R., Hart, K., Manibusan, B., McCarty, D. & McConnell, K. J. State- and county-level geographic variation in opioid use disorder, medication treatment, and opioid-related overdose among medicaid enrollees. JAMA Health Forum. 4(6), e231574 (2023).","journal-title":"JAMA Health Forum."},{"issue":"12","key":"52032_CR22","doi-asserted-by":"publisher","first-page":"e0269509","DOI":"10.1371\/journal.pone.0269509","volume":"17","author":"A Acharya","year":"2022","unstructured":"Acharya, A. et al. Exploring county-level spatio-temporal patterns in opioid overdose related emergency department visits. PLOS One 17(12), e0269509 (2022).","journal-title":"PLOS One"},{"issue":"5","key":"52032_CR23","doi-asserted-by":"publisher","first-page":"219","DOI":"10.5435\/JAAOS-D-19-00798","volume":"29","author":"SA Traven","year":"2021","unstructured":"Traven, S. A. et al. Notable variability in opioid-prescribing practices after common orthopaedic procedures. J. Am. Acad. Orthop. Surg. 29(5), 219\u2013226 (2021).","journal-title":"J. Am. Acad. Orthop. Surg."},{"issue":"23","key":"52032_CR24","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.1056\/NEJMp2102323","volume":"385","author":"CL Barry","year":"2021","unstructured":"Barry, C. L. & Saloner, B. Using policy tools to improve population health\u2014Combating the U.S. Opioid crisis. N. Engl. J. Med. 385(23), 2113\u20132116 (2021).","journal-title":"N. Engl. J. Med."},{"issue":"10","key":"52032_CR25","doi-asserted-by":"publisher","first-page":"3706","DOI":"10.1111\/bcp.14798","volume":"87","author":"CJ De Oliveira","year":"2021","unstructured":"De Oliveira, C. J. et al. Variations in long-term opioid therapy definitions: A systematic review of observational studies using routinely collected data (2000\u20132019). Br. J. Clin. Pharmacol. 87(10), 3706\u20133720 (2021).","journal-title":"Br. J. Clin. Pharmacol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-52032-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-52032-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-52032-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T15:02:28Z","timestamp":1705417348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-52032-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,16]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["52032"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-52032-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,16]]},"assertion":[{"value":"13 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1432"}}