Table 2. Prior Mental Health Conditions and Treatments and Long-term Opioid Therapy Among 1 000 453 Adolescents.
| Prior Mental Health Factor | Long-term Opioids per 1000 Recipients Within 3 ya | Hazard Ratio (95% CI) | ||
|---|---|---|---|---|
| No Predictor | With Predictor | Unadjustedb | Adjustedc | |
| Anxiety | ||||
| Anxiety disorder | 2.8 | 8.0 | 2.72 (2.42-3.06) | 2.69 (2.39-3.03) |
| Benzodiazepine | 2.8 | 12.2 | 4.07 (3.56-4.66) | 3.88 (3.39-4.45) |
| Mood | ||||
| Bipolar or other mood disorder | 2.8 | 10.1 | 3.33 (2.86-3.87) | 3.28 (2.81-3.82) |
| Depressive disorder | 2.6 | 9.0 | 3.15 (2.86-3.46) | 3.01 (2.73-3.31) |
| Suicide attempt or self-injury | 3.0 | 6.0 | 3.05 (1.73-5.38) | 3.16 (1.79-5.58) |
| Mood stabilizer | 2.9 | 10.3 | 3.12 (2.46-3.96) | 3.01 (2.37-3.82) |
| SNRI | 2.9 | 14.8 | 4.58 (3.59-5.85) | 3.93 (3.08-5.02) |
| SSRI | 2.6 | 9.1 | 3.11 (2.82-3.43) | 2.95 (2.67-3.25) |
| Neurodevelopment | ||||
| ADHD | 2.9 | 4.5 | 1.64 (1.46-1.84) | 1.73 (1.54-1.95) |
| ADHD medication | 2.8 | 4.7 | 1.67 (1.50-1.85) | 1.74 (1.56-1.94) |
| Psychosis | ||||
| Schizophrenia spectrum disorder | 3.0 | 6.7 | 3.02 (2.11-4.32) | 2.96 (2.07-4.24) |
| Antipsychotic | 2.8 | 11.3 | 3.59 (3.08-4.18) | 3.58 (3.08-4.17) |
| Sleep | ||||
| Sleep disorder | 2.9 | 10.8 | 3.58 (3.01-4.24) | 3.53 (2.97-4.19) |
| Nonbenzodiazepine hypnotic | 2.9 | 24.2 | 6.93 (5.65-8.50) | 6.15 (5.01-7.55) |
| Substance use | ||||
| Nonopioid SUD | 2.8 | 12.7 | 4.33 (3.75-5.00) | 4.02 (3.48-4.65) |
| OUD | 3.0 | 27.5 | 9.74 (6.41-14.82) | 8.90 (5.85-13.54) |
| OUD medication | 3.0 | 22.4 | 9.83 (4.69-20.63) | 8.50 (4.05-17.84) |
| Psychotherapy | ||||
| For any diagnosis | 2.6 | 5.9 | 2.14 (1.95-2.34) | 2.10 (1.92-2.30) |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; OUD, opioid use disorder; SNRI, serotonin-norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; SUD, substance use disorder.
a
Three-year cumulative incidence per 1000 opioid recipients.
b
Unadjusted Cox proportional hazards regression analysis.
c
Adjusted for sex, index age, and index year.