{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T18:47:18Z","timestamp":1785696438730,"version":"3.56.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"8","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["HU00012220065"],"award-info":[{"award-number":["HU00012220065"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of War"},{"DOI":"10.13039\/100003896","name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Veterans Health Administration"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study quantified time-to-opioid use disorder diagnosis after low back pain diagnosis in military-connected patients and evaluated predictors of opioid use disorder over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Time-to-event cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data obtained from the Department of War and Veterans Administration Infrastructure for Clinical Intelligence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>National sample of active duty, retired, and veteran service members diagnosed with low back pain July 2016\u2013March 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The primary outcome was time-to-opioid use disorder diagnosis up to 52\u2009weeks after low back pain diagnosis. Fixed covariates: Patient characteristics, diagnosis site, and comorbidity scores. Time-dependent covariates: Co-occurring substance use, psychiatric, and medical conditions, and pharmacological and non-pharmacological pain treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3\u200a444\u200a921 patients, 20\u200a076 (0.6%) received an opioid use disorder diagnosis within 52\u2009weeks after low back pain diagnosis. Average hazard ratios for opioid use disorder were significantly higher for retired service members and veterans versus active duty personnel, and for those with nicotine dependence, other substance use, and psychiatric comorbidities. Statistically significant time-varying variables included veteran status, greater medical comorbidities, purchased care system for low back pain diagnosis; substance use disorder, other pain, and obesity; days supply of opioids; days of secondary and tertiary pain therapies; and number of antidepressant, sedative, and non-opioid prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the need for opioid use disorder mitigation efforts for veterans and retired service members with low back pain, particularly those with co-occurring substance use and psychiatric diagnoses, who are prescribed opioids, or who receive intensive pain treatment close to their low back pain diagnosis date.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnag045","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:43:18Z","timestamp":1773924198000},"page":"867-878","source":"Crossref","is-referenced-by-count":0,"title":["Opioid use disorder diagnosis after low back pain diagnosis in active duty, retired, and veteran service members: A time-to-event cohort study"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4863-1891","authenticated-orcid":false,"given":"Corinne N","family":"Kacmarek","sequence":"first","affiliation":[{"name":"VA Maryland Health Care System, VISN 5 Capitol Mental Illness Research, Education, and Clinical Center (MIRECC) , Baltimore, MD,","place":["United States"]},{"name":"Department of Psychiatry, Division of Psychiatric Services Research, University of Maryland School of Medicine , Baltimore, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6289-8886","authenticated-orcid":false,"given":"Letitia E","family":"Travaglini","sequence":"additional","affiliation":[{"name":"VA Maryland Health Care System, VISN 5 Capitol Mental Illness Research, Education, and Clinical Center (MIRECC) , Baltimore, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista B","family":"Highland","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Uniformed Services University of Health Sciences , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Velosky","sequence":"additional","affiliation":[{"name":"Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University , Bethesda, MD,","place":["United States"]},{"name":"Henry M. 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