{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:09Z","timestamp":1787022909773,"version":"build-2736575974"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Little is known about the risk for overdose after opioid prescription. We assessed associations between the type of opioid, quantity dispensed, daily dose, and risk for overdose among adolescents who were previously opioid naive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Retrospective analysis of 1\u2009146\u2009412 privately insured adolescents ages 11 to 17 years in the United States captured in the Truven MarketScan commercial claims data set from January 2007 to September 2015. Opioid overdose was defined as any emergency department visit, inpatient hospitalization, or outpatient health care visit during which opioid overdose was diagnosed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among our cohort, 725 participants (0.06%) experienced an opioid overdose, and the overall rate of overdose events was 28 events per 100\u2009000 observed patient-years. Receiving \u226530 opioid tablets was associated with a 35% increased risk for overdose compared to receiving \u226418 tablets (hazard ratio [HR] = 1.35; 95% confidence interval: 1.05\u20131.73; P = .02). Daily prescribed opioid dose was not independently associated with an increased risk for overdose. Tramadol exposure was associated with a 2.67-fold increased risk for opioid overdose compared to receiving oxycodone (adjusted HR = 2.67; 95% confidence interval: 1.90\u20133.75; P &amp;lt; .0001). Adolescents with preexisting mental health conditions demonstrated increased risk for overdose, with HRs ranging from 1.65 (anxiety) to 3.09 (substance use disorders).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>One of 1600 (0.06%) previously opioid-naive adolescents who received a prescription for opioids experienced an opioid overdose a median of 1.75 years later that resulted in medical care. Preexisting mental health conditions, use of tramadol, and higher number of dispensed tablets (&amp;gt;30 vs &amp;lt;18) were associated with an increased risk of opioid overdose.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2018-4070","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T08:25:18Z","timestamp":1569918318000},"source":"Crossref","is-referenced-by-count":32,"title":["Associations Between Opioid Prescribing Patterns and Overdose Among Privately Insured Adolescents"],"prefix":"10.1542","volume":"144","author":[{"given":"Cornelius B.","family":"Groenewald","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine and"},{"name":"Center for Child Health, Behavior, and Development, Seattle Children\u2019s Research Institute, Seattle, Washington; and"},{"name":"Harborview Injury Prevention and Research Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Center for Child Health, Behavior, and Development, Seattle Children\u2019s Research Institute, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya M.","family":"Palermo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine and"},{"name":"Center for Child Health, Behavior, and Development, Seattle Children\u2019s Research Institute, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Van Cleve","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine and"},{"name":"Harborview Injury Prevention and Research Center, Seattle, Washington"},{"name":"Surgical Outcomes Research Center, School of Medicine, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,11,1]]},"reference":[{"issue":"282","key":"2021121100042473900_B1","first-page":"1","article-title":"Drug overdose deaths among adolescents aged 15-19 in the United States: 1999-2015","author":"Curtin","year":"2017","journal-title":"NCHS Data Brief"},{"issue":"3\u20134","key":"2021121100042473900_B2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/15360288.2017.1407860","article-title":"Prevalence of and comorbid health conditions associated with pediatric prescription opioid use in the US","volume":"31","author":"Banerjee","year":"2017","journal-title":"J Pain Palliat Care Pharmacother"},{"issue":"1","key":"2021121100042473900_B3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jpain.2018.07.007","article-title":"Associations between adolescent chronic pain and prescription opioid misuse in adulthood","volume":"20","author":"Groenewald","year":"2019","journal-title":"J Pain"},{"issue":"13","key":"2021121100042473900_B4","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/jama.2011.370","article-title":"Association between opioid prescribing patterns and opioid overdose-related deaths","volume":"305","author":"Bohnert","year":"2011","journal-title":"JAMA"},{"issue":"5","key":"2021121100042473900_B5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/M17-0865","article-title":"Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 national survey on drug use and health","volume":"167","author":"Han","year":"2017","journal-title":"Ann Intern Med"},{"issue":"15","key":"2021121100042473900_B6","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2016.1464","article-title":"CDC guideline for prescribing opioids for chronic pain\u2013United States, 2016","volume":"315","author":"Dowell","year":"2016","journal-title":"JAMA"},{"issue":"18","key":"2021121100042473900_B7","doi-asserted-by":"crossref","first-page":"E659","DOI":"10.1503\/cmaj.170363","article-title":"Guideline for opioid therapy and chronic noncancer pain","volume":"189","author":"Busse","year":"2017","journal-title":"CMAJ"},{"issue":"5","key":"2021121100042473900_B8","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1001\/jamapediatrics.2014.3583","article-title":"Leftover prescription opioids after minor procedures: an unwitting source for accidental overdose in children","volume":"169","author":"Voepel-Lewis","year":"2015","journal-title":"JAMA Pediatr"},{"key":"2021121100042473900_B9","volume-title":"The MarketScan Databases for Life Sciences Researchers","author":"Hansen","year":"2016"},{"key":"2021121100042473900_B10","unstructured":"Centers for Disease Control and Prevention. 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