{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:52:44Z","timestamp":1768571564477,"version":"3.49.0"},"posted":{"date-parts":[[2025,9,12]]},"group-title":"Epidemiology","reference-count":35,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,9,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The purpose of this study is to examine whether chronic prescription opioid use in individuals with MS is associated with adverse medical outcomes and acute medical service utilization.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    This propensity score-matched, retrospective, cohort study included data from 15,377 Veterans with MS obtained from national VA administrative data. Veterans with filled prescriptions for chronic opioid therapy (\n                    <jats:italic>n<\/jats:italic>\n                    =1,908) in 2017 were matched 1:1 and compared to those not prescribed chronic opioid therapy using logistic regression models adjusted for propensity score, age, sex, race, and ethnicity. Outcomes included falls, fractures, wounds, and all-cause mortality, as well as acute inpatient and emergency department utilization, and intensive care unit admission in 2018.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    The chronic opioid group had a higher likelihood of a fall (OR\n                    <jats:sub>adj<\/jats:sub>\n                    =1.77, 95% CI, 1.03\u2013 3.02,\n                    <jats:italic>p<\/jats:italic>\n                    =0.038), inpatient admission (OR\n                    <jats:sub>adj<\/jats:sub>\n                    =1.21, 95% CI, 1.02\u20131.43,\n                    <jats:italic>p<\/jats:italic>\n                    =0.028), and emergency department visit (OR\n                    <jats:sub>adj<\/jats:sub>\n                    =1.25, 95% CI, 1.09\u20131.43,\n                    <jats:italic>p<\/jats:italic>\n                    =0.001). Significant differences were not detected between those prescribed and not prescribed chronic opioid therapy on fractures, wounds, all-cause mortality, and intensive care unit admission, although in all cases the occurrence of these outcomes was higher in the opioid group.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Chronic prescription opioid use among Veterans with MS was associated with a higher likelihood of adverse outcome (falls) and higher intensity health care utilization (inpatient admissions and emergency department visits) in the following year. Education regarding MS-specific risks of opioid use should be provided at initial prescription and re-evaluation of risks versus benefits should be conducted regularly.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.09.09.25335375","type":"posted-content","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T23:35:14Z","timestamp":1757720114000},"source":"Crossref","is-referenced-by-count":0,"title":["Chronic prescription opioid use in MS: Associations with adverse outcomes and acute medical service utilization"],"prefix":"10.64898","author":[{"given":"Aaron P.","family":"Turner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Malte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Arewasikporn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Hawkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Suri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Burns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven L.","family":"Leipertz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodie K.","family":"Haselkorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025091517452552000_2025.09.09.25335375v1.1","doi-asserted-by":"publisher","DOI":"10.1191\/1352458503ms939oa"},{"key":"2025091517452552000_2025.09.09.25335375v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2005.01.001"},{"key":"2025091517452552000_2025.09.09.25335375v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.08.024"},{"key":"2025091517452552000_2025.09.09.25335375v1.4","unstructured":"Maloni H. 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