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Outcome measures were opioid initiations (dispensed within 7\u00a0days of discharge) and long\u2010term use (90\u2009days of continuous exposure, 90\u2013270\u2009days after initiation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 16\u2009153\u2009096 admissions by 4.2 million opioid\u2010na\u00efve adults; 39.0% were ED presentations without hospital admission, 16.8% hospital admissions via ED and 44.2% direct hospital admissions. Opioids were initiated post\u2010discharge for 6.2% of ED, 8.3% of hospital via ED and 10.0% of direct hospital admissions; of these 1.0%, 2.5% and 0.5% progressed to long\u2010term opioid use, respectively. Initiation was lowest in obstetric admissions without surgery (1.0%), and highest among trauma admissions (25.4%), obstetric admissions with surgical intervention (19.8%) and non\u2010trauma surgical admissions (12.0%). Long\u2010term use was highest among medical admissions via ED (3.5%), trauma admissions (2.3%) and ED alone (1.0%). From 2014 to 2020, overall opioid initiations decreased 16% from 8.7% to 7.2%, and long\u2010term opioid use decreased 33% from 1.3% to 0.8%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both opioid initiation and long\u2010term use decreased over time; however, the higher rates of long\u2010term use following trauma, and medical admissions via ED, warrant further surveillance. Strategies supporting appropriate prescribing and access to multidisciplinary pain services will facilitate best practice care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16093","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T04:19:46Z","timestamp":1716869986000},"page":"2111-2123","source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010term prescribed opioid use after hospitalization or emergency department presentation among opioid na\u00efve adults (2014\u20132020)\u2014A population\u2010based descriptive cohort study"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9038-8050","authenticated-orcid":false,"given":"Malcolm B.","family":"Gillies","sequence":"first","affiliation":[{"name":"Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4901-4182","authenticated-orcid":false,"given":"Kendal","family":"Chidwick","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrianna","family":"Bharat","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2371-1441","authenticated-orcid":false,"given":"Ximena","family":"Camacho","sequence":"additional","affiliation":[{"name":"Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Currow","sequence":"additional","affiliation":[{"name":"Faculty of Science, Medicine and Health University of Wollongong  Wollongong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0452-8470","authenticated-orcid":false,"given":"Natasa","family":"Gisev","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7137-6855","authenticated-orcid":false,"given":"Sallie\u2010Anne","family":"Pearson","sequence":"additional","affiliation":[{"name":"Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00161\u20106"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/20494637211013052"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1501822"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302843"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7789"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12937"},{"key":"e_1_2_11_8_1","unstructured":"ChrzanowskaA ManN SutherlandR DegenhardtL PeacockA.Trends in overdose and other drug\u2010induced deaths in Australia 1997\u20132020. 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