{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T06:28:31Z","timestamp":1782368911673,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University of California\u2013Optum Labs Research"},{"name":"Department of Family and Community Medicine"},{"DOI":"10.13039\/100005595","name":"University of California","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005595","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of California Davis"},{"name":"Center for Healthcare Policy and Research"},{"DOI":"10.13039\/100005595","name":"University of California","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005595","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Davis School of Medicine Dean\u2019s Office"},{"name":"Women\u2019s Health Research"},{"DOI":"10.13039\/100000071","name":"NICHD","doi-asserted-by":"publisher","award":["K12 HD051958"],"award-info":[{"award-number":["K12 HD051958"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Building Interdisciplinary Research Careers in Women\u2019s Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Tapering of chronic opioids has increased, with subsequent reports of exacerbated pain among patients who tapered. We aimed to evaluate the association between opioid dose tapering and subsequent pain-related healthcare utilization (emergency department [ED] visits, hospitalizations and primary care visits).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design, Setting, and Subjects<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study from years 2015\u20132019 using data from the Optum Labs Data Warehouse that contains de-identified retrospective administrative claims data for commercial and Medicare Advantage enrollees in the United States. Adults aged \u226518\u2009years who were prescribed stable doses of opioids, \u226550 morphine milligram equivalents (MME)\/day, during a 12-month baseline period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Tapering was defined as \u226515% relative reduction in mean daily opioid dose during one of 6 overlapping 60-day periods. Tapered patient-periods were subclassified as tapered-and-continued (MME\u2009&amp;gt;\u20090) vs tapered-and-discontinued (MME\u2009=\u20090). We modeled monthly counts of visits for pain diagnoses up to 12\u2009months after cohort entry using negative binomial regression as a function of tapering, baseline utilization, and patient level-covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 47\u200a033 patients, 13\u200a793 patients tapered. Compared to no taper, any taper was associated with more ED visits for pain (adjusted incidence rate ratio [aIRR] 1.21, 95% confidence interval [CI]: 1.11\u20131.30), tapered then continued status was associated with more ED visits (aIRR 1.23, CI: 1.14\u20131.32) and hospitalizations (aIRR 1.14, CI: 1.03\u20131.27) f-or pain, and tapered-and-discontinued was associated with fewer primary care visits for pain (aIRR 0.68, CI: 0.61\u20130.76).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These associations suggest that opioid tapering may lead to increased emergency and hospital utilization for acute pain and possibly a decreased perceived need for primary care for those whose opioids were discontinued.<\/jats:p>\n               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