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This study aimed to identify patient and prescription characteristics associated with subsequent risk of opioid use disorder or overdose during the year after an opioid is first dispensed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Commercial health insurance claims in a large United States (US) database from 2006 to 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Youth age 11 to 25\u00a0years filling an initial opioid prescription (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03\u2009278\u2009990).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was development of an \u2018opioid\u2010related complication\u2019 (a diagnosis of opioid use disorder or opioid\u2010related overdose) during the subsequent 12\u00a0months. Exposures of interest were patient (sociodemographic information, and physical and mental health diagnoses) and prescription characteristics (opioid formulation, dose, and duration).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among youth filling an initial opioid prescription, median age was 18\u00a0years (interquartile range [IQR] = 16\u201321) and 56.1% were female. During the subsequent 12\u00a0months, 10\u2009405 (0.3%) youth experienced an opioid\u2010related complication. Conditions associated with increased risk included mood\/anxiety disorders (adjusted relative risk [aRR] = 4.45; 95% CI = 4.25\u20134.66) and substance use (aRR = 20.77; 95% CI = 19.74\u201321.84). Comorbid substance use disorders were present among 72.8% of youth experiencing an opioid\u2010related complication and included alcohol (33.4%), cannabis (33.0%), nicotine (43.2%), and other substance use disorders (75.5%). Long\u2010acting opioids (aRR = 2.59; 95% CI = 2.18\u20133.09) and longer durations were associated with increased risk (7\u201314\u00a0days: aRR = 1.15; 95% CI = 1.08\u20131.22; \u226515\u00a0days: aRR = 1.96; 95% CI = 1.80\u20132.12) compared with short\u2010acting formulations and durations \u22643\u00a0days, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among United States youth, complications after an initial opioid prescription appear to be relatively rare and appear to be associated with mood\/anxiety disorders, substance use, comorbid substance use disorders, and prescriptions involving long\u2010acting opioids or long durations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15487","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T07:29:40Z","timestamp":1616138980000},"page":"2790-2800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Opioid use disorder and overdose among youth following an initial opioid prescription"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3189-6199","authenticated-orcid":false,"given":"Scott E.","family":"Hadland","sequence":"first","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics Boston University School of Medicine  Boston MA USA"},{"name":"Grayken Center for Addiction and Department of Pediatrics Boston Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7524-0178","authenticated-orcid":false,"given":"Sarah M.","family":"Bagley","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics Boston University School of Medicine  Boston MA USA"},{"name":"Grayken Center for Addiction and Department of Pediatrics Boston Medical Center  Boston MA USA"},{"name":"Section of General Internal Medicine, Department of Medicine Boston University School of Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mam Jarra","family":"Gai","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine Boston Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel J.","family":"Earlywine","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9401-2998","authenticated-orcid":false,"given":"Samantha F.","family":"Schoenberger","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Boston University School of Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1559-3983","authenticated-orcid":false,"given":"Jake R.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Barocas","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine Boston Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Drug Overdose Deaths in the United States, 1999\u20132018. 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