{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:51:47Z","timestamp":1775148707432,"version":"3.50.1"},"reference-count":84,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Background:<\/jats:title>\n Chronic pain management with opioids after spinal cord injury (SCI) has been shown to be ineffective, leading to overuse in length and dosage.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To assess how the length of opioid use affects associated complications and healthcare usage and costs over 12 months following injury.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Adults with SCI from MarketScan Database (2000-2021) were followed up 12 months pre- and post-injury. Opioid use (OU) was screened from injury. Individuals were then classified accordingly: no use (No OU), 3 months use (OU 3m), 3 to 6 months use (OU 3-6m), and 6 to 12 months use (OU 6-12m). Related complications, healthcare utilization, and payment outcomes were compared using multivariable generalized linear regressions.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Cohort was composed of 9630 individuals (median age 54; 59% males). Prolonged-use group (OU 6-12m) had a different profile compared to the No OU group: younger, higher rates of males, bone fracture, thoracic injuries, and Medicaid insurance (median age 49 vs. 58; males 62% vs. 56%, fracture 58% vs. 50%, thoracic 29% vs. 21%, Medicaid 32% vs. 24%; all\n P<\/jats:italic>\n s < .0001). A year after SCI, opioid-related complications were constipation, respiratory depression, hypotension, urinary retention, and nausea\/vomiting, with an associated cost 2.4 times higher in OU 6-12m compared to No OU ($6958 vs. $2842). Opioid users (>3 months) had more ER visits and higher hospitalization rates compared to No OU. Combined payments (ER, hospitalizations, PT\/OT\/SLT, outpatient services, and medication refills) were higher for OU 6-12 ($33,014) and OU 3-6m ($22,351) compared to No OU ($13,896;\n P<\/jats:italic>\n < .0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Considering risk profiles may predict prolonged opioid use and could help clinicians design care management plans to reduce complications and the associated healthcare utilization and payments.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci24-00052","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T16:36:52Z","timestamp":1763483812000},"page":"175-187","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Opioid Use Duration on Complications and Healthcare Utilization and Costs in Spinal Cord Injury"],"prefix":"10.46292","volume":"31","author":[{"given":"Elsa","family":"Alvarez Madrid","sequence":"first","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"},{"name":"Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Kimmell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"},{"name":"Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxwell","family":"Boakye","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"},{"name":"Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Ugiliweneza","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, School of Medicine, University of Louisville, Louisville, Kentucky"},{"name":"Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"key":"b1","series-title":"Spinal Cord Injuries","author":"Bennett J","year":"2024","unstructured":"Bennett J, Das JM, Emmady PD. 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