{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:22:46Z","timestamp":1788434566173,"version":"build-2803163510"},"reference-count":88,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"\n Background<\/jats:title>\n Postinjury pain is a well-known debilitating complication of spinal cord injury (SCI), often resulting in long-term, high-dose opioid use with the potential for dependence. There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%,\n p<\/jats:italic>\n < .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26\u201343). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci22-00026","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T17:36:28Z","timestamp":1676482588000},"page":"118-130","source":"Crossref","is-referenced-by-count":6,"title":["Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database"],"prefix":"10.46292","volume":"29","author":[{"given":"Riley L.","family":"Wilkinson","sequence":"first","affiliation":[{"name":"University of Louisville School of Medicine, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Herrity","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Lousville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dengzhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Lousville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayur","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Dietz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Khattar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Nuno","sequence":"additional","affiliation":[{"name":"Department of Public Health Science, University of California, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doniel","family":"Drazin","sequence":"additional","affiliation":[{"name":"College of Medicine Pacific Northwest, Yamika, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell","family":"Boakye","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Lousville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Ugiliweneza","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Lousville, Kentucky"},{"name":"Department of Health Management and Systems Science, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1945-5763-29-1-118-b1","series-title":"Spinal Cord Ser Cases","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1038\/s41394-019-0189-5","article-title":"Pulse article: Opioid prescription for pain after spinal cord damage (SCD), differences from recommended guidelines, and a proposed algorithm for the use of opioids for pain after SCD","volume":"5","year":"2019","unstructured":"Wong\n TK,\n \n \n Alexander\n MS,\n \n \n New\n PW,\n \n \n Delgado\n AD,\n \n \n Bryce\n TN.\n \n \n Pulse article: Opioid prescription for pain after spinal cord damage (SCD), differences from recommended guidelines, and a proposed algorithm for the use of opioids for pain after SCD.\n\t\t\t\t\tSpinal Cord Ser Cases.\n\t\t\t\t\t2019;\n\t\t\t\t\t5:\n\t\t\t\t\t39.\n\t\t\t\t\tdoi:10.1038\/s41394-019-0189-5"},{"key":"i1945-5763-29-1-118-b2","series-title":"Exp 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J.\n\t\t\t\t\tdoi:10.1016\/j.spinee.2021.04.013"},{"issue":"5","key":"i1945-5763-29-1-118-b9","series-title":"Arch Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.apmr.2017.12.004","article-title":"Dose and duration of opioid use in propensity score-matched, privately insured opioid users withand without spinal cord injury","volume":"99","year":"2018","unstructured":"Hand\n BN,\n \n \n Krause\n JS,\n \n \n Simpson\n KN.\n \n \n Dose and duration of opioid use in propensity score-matched, privately insured opioid users withand without spinal cord injury.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2018;\n\t\t\t\t\t99(\n\t\t\t\t\t5):\n\t\t\t\t\t855\u2013\n\t\t\t\t\t861.\n\t\t\t\t\tdoi:10.1016\/j.apmr.2017.12.004"},{"issue":"6","key":"i1945-5763-29-1-118-b10","series-title":"Pain","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1097\/j.pain.0000000000001202","article-title":"Use of prescription opioids before and after an operation for 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spinal cord injury","volume":"99","year":"2018","unstructured":"Krause\n JS,\n \n \n Cao\n Y,\n \n \n DiPiro\n ND,\n \n \n Cuddy\n E.\n \n \n Personality, high-risk behaviors, and elevated risk of unintentional deaths related to drug poisoning among individuals with spinal cord injury.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2018;\n\t\t\t\t\t99(\n\t\t\t\t\t10):\n\t\t\t\t\t1941\u2013\n\t\t\t\t\t1948.\n\t\t\t\t\tdoi:10.1016\/j.apmr.2018.05.013"},{"issue":"7","key":"i1945-5763-29-1-118-b41","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1038\/s41393-018-0078-y","article-title":"Changes in psychotropic prescription medication use and their relationship with mortality among people with traumatic spinal cord injury","volume":"56","year":"2018","unstructured":"Cao\n Y,\n \n \n Clark\n JMR,\n \n \n Krause\n JS.\n \n \n Changes in psychotropic prescription medication use and their relationship with mortality among people with traumatic spinal cord 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R\u00fcdell\n K,\n \n \n Roland\n CL,\n \n \n Masters\n ET.\n \n \n Economic burden of prescription opioid misuse and abuse: A systematic review.\n\t\t\t\t\tJ Pain Palliat Care Pharmacother.\n\t\t\t\t\t2015;\n\t\t\t\t\t29(\n\t\t\t\t\t4):\n\t\t\t\t\t388\u2013\n\t\t\t\t\t400.\n\t\t\t\t\tdoi:10.3109\/15360288.2015.1101641"},{"issue":"2","key":"i1945-5763-29-1-118-b44","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/sc.2013.147","article-title":"Race-ethnicity and poverty after spinal cord injury","volume":"52","year":"2014","unstructured":"Krause\n JS,\n \n \n Dismuke\n CE,\n \n \n Acuna\n J,\n \n \n .\n\t\t\t\t\tRace-ethnicity and poverty after spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2014;\n\t\t\t\t\t52(\n\t\t\t\t\t2):\n\t\t\t\t\t133\u2013\n\t\t\t\t\t138.\n\t\t\t\t\tdoi:10.1038\/sc.2013.147"}],"container-title":["Topics in Spinal Cord Injury 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