Table 3.
Associations of patient and opioid prescription factors with diagnosis of opioid use disorder or opioid overdose during the year after an opioid prescription among 3,278,990 youth.
|
Characteristic |
Unadjusted RR (95% CI) | Adjusteda RR (95% CI) |
|---|---|---|
| Patient factors | ||
| Age, years | ||
| 11–13 | Reference | Reference |
| 14–16 | 6.76 (5.36 – 8.53) | 3.54 (2.80 – 4.47) |
| 17–19 | 16.33 (13.02 – 20.47) | 5.65 (4.50 – 7.10) |
| 20–22 | 26.95 (21.51 – 33.78) | 7.31 (5.81 – 9.19) |
| 23–25 | 21.56 (17.19 – 27.05) | 6.17 (4.90 – 7.76) |
| Sex | ||
| Female | Reference | Reference |
| Male | 2.14 (2.06 – 2.22) | 2.00 (1.91 – 2.08) |
| Location | ||
| Rural | Reference | Reference |
| Urban | 1.20 (1.13 – 1.27) | 1.15 (1.09 – 1.20) |
| Pregnancyb | ||
| No | Reference | Reference |
| Yes | 0.95 (0.88 – 1.02) | 0.91 (0.84 – 0.99) |
| Acute pain conditionc | ||
| No | Reference | Reference |
| Yes | 1.06 (1.01 – 1.11) | 0.88 (0.84 – 0.93) |
| Chronic pain conditionb | ||
| No | Reference | Reference |
| Yes | 1.95 (1.86 – 2.04) | 1.15 (1.09 – 1.20) |
| Intellectual disability, learning disorder, or developmental disordera | ||
| No | Reference | Reference |
| Yes | 1.46 (1.27 – 1.68) | 0.84 (0.73 – 0.96) |
| Mood or anxiety disorderb | ||
| No | Reference | Reference |
| Yes | 11.17 (10.73 – 11.62) | 4.45 (4.25 – 4.66) |
| Psychosisb | ||
| No | Reference | Reference |
| Yes | 14.68 (13.65 – 15.79) | 1.35 (1.25 – 1.45) |
| Attention deficit hyperactivity disorderb | ||
| No | Reference | Reference |
| Yes | 2.68 (2.55 – 2.83) | 1.10 (1.04 – 1.16) |
| Trauma or stress-related conditionb | ||
| No | Reference | Reference |
| Yes | 4.22 (4.01 – 4.44) | 1.42 (1.35 – 1.50) |
| Conduct disorder or antisocial personality disorderb | ||
| No | Reference | Reference |
| Yes | 6.08 (5.58 – 6.63) | 1.18 (1.08 – 1.30) |
| Other substance use disorderb | ||
| No | Reference | Reference |
| Yes | 45.45 (43.53 – 47.45) | 20.77 (19.74 – 21.84) |
| Prescription factors | ||
| Long-acting opioid | ||
| No | Reference | Reference |
| Yes | 9.49 (7.94 – 11.34) | 2.59 (2.18 – 3.09) |
| Daily dose, morphine milligram equivalents | ||
| < 30 | Reference | Reference |
| 30–59 | 0.91 (0.87 – 0.95) | 0.95 (0.91 – 0.99) |
| 60–89 | 0.89 (0.83 – 0.96) | 0.90 (0.83 – 0.96) |
| 90–119 | 0.97 (0.87 – 1.08) | 0.92 (0.83 – 1.03) |
| ≥ 120 | 2.04 (1.83 – 2.28) | 1.23 (1.11 – 1.37) |
| Duration of prescription, days | ||
| 1–3 | Reference | Reference |
| 4–6 | 0.93 (0.89 – 0.97) | 0.96 (0.92 – 1.01) |
| 7–14 | 1.25 (1.17 – 1.32) | 1.15 (1.08 – 1.22) |
| ≥ 15 | 3.01 (2.79 – 3.24) | 1.96 (1.80 – 2.12) |
a.
Adjusted for all other covariates listed in the table
b.
Diagnosed within the 6 months preceding or 12 months following the initial opioid prescription
c.
Diagnosed within the 14 days preceding or following the initial opioid prescription