• Teresa M Bell, Jodi L Raymond, Alejandro C Mongalo, Zachary W Adams, Thomas M Rouse, LeRanna Hatcher, Katie Russell, and Aaron E Carroll.
• Department of Surgery, University of Utah, School of Medicine, Salt Lake City, UT 84121.
• Ann. Surg. 2022 Dec 1; 276 (6): e955e960e955-e960.

ObjectiveThis study aims to determine if outpatient opioid prescriptions are associated with future SUD diagnoses and overdose in injured adolescents 5 years following hospital discharge.Summary Of Background DataApproximately, 1 in 8 adolescents are diagnosed with an SUD and 1 in 10 experience an overdose in the 5 years following injury. State laws have become more restrictive on opioid prescribing by acute care providers for treating pain, however, prescriptions from other outpatient providers are still often obtained.MethodsThis was a retrospective cohort study of patients ages 12-18 admitted to 2 level I trauma centers. Demographic and clinical data contained in trauma registries were linked to a regional database containing 5 years of electronic health records and prescription data. Regression models assessed whether number of outpatient opioid prescription fills after discharge at different time points in recovery were associated with a new SUD diagnosis or overdose, while controlling for demographic and injury characteristics, and depression and posttraumatic stress disorder diagnoses.ResultsWe linked 669 patients (90.9%) from trauma registries to a regional health information exchange database. Each prescription opioid refill in the first 3 months after discharge increased the likelihood of new SUD diagnoses by 55% (odds ratio: 1.55, confidence interval: 1.04-2.32). Odds of overdose increased with ongoing opioid use over 2-4 years post-discharge ( P = 0.016-0.025).ConclusionsShort-term outpatient opioid prescribing over the first few months of recovery had the largest effect on developing an SUD, while long-term prescription use over multiple years was associated with a future overdose.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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