Patterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study

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10 Scopus citations


A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). We extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. Using latent growth mixture modelling, we identified four distinguishable dose trajectories: low (53%), moderate (29%), escalating (13%), and rapidly escalating (5%). Compared to low dose trajectory, those in the rapidly escalating dose trajectory were proportionately more European-American (59% rapidly escalating vs. 38% low); had a higher prevalence of HIV (31% vs. 29%) and hepatitis C (18% vs. 12%); and during follow-up, had a higher incidence of OUD diagnoses (13% vs. 3%); were hospitalised more often [18.1/100 person-years (PYs) vs. 12.5/100 PY]; and had higher all-cause mortality (4.7/100 PY vs. 1.8/100 PY, all p < 0.0001). These measures can potentially be used in future prevention research, including genetic discovery.

Original languageEnglish
Pages (from-to)3340-3349
Number of pages10
JournalAIDS and Behavior
Issue number12
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
This work was supported by US National Institutes of Health, including Grants from National Institute on Alcohol Abuse and Alcoholism (U24-AA020794, U01-AA020790, U10-AA013566-completed to ACJ) and National Institute on Drug Abuse (NIDA R01-DA040471, R01-DA12690). Additional support was provided by the US Department of Veterans Affairs (i01-BX003341), Yale School of Medicine Drug Use, Addiction, and HIV Research Scholars Program (DAHRS K12-DA033312), and Agency for Healthcare Research and Quality (AHRQ U19-HS021112 and R18-HS023258). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The views presented in this paper are the authors’ and not necessarily those of the Department of Veterans Affairs or the United States Government.

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.


  • Electronic health records
  • Opioids
  • Pharmacoepidemiology
  • Pharmacy fill data
  • Phenotype

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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