Associations of mental health and family background with opioid analgesic therapy: a nationwide Swedish register-based study

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Quinn, Patrick D.Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States (author)

Associations of mental health and family background with opioid analgesic therapy : a nationwide Swedish register-based study

Article/chapterEnglish2019

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2019-06-11
Elsevier,2019
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-77733
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-77733URI
https://doi.org/10.1097/j.pain.0000000000001643DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:142961769URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies:United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Drug Abuse (NIDA) R00DA040727National Center for Advancing Translational Sciences of the National Institutes of Health under a Clinical and Translational Sciences Award TL1TR001107Swedish Initiative for Research on Microdata in the Social and Medical Sciences
There is evidence of greater opioid prescription to individuals in the United States with mental health conditions. Whether these associations generalize beyond the US prescription environment and to familial mental health and socioeconomic status (SES) has not been examined comprehensively. This study estimated associations of diverse preexisting mental health diagnoses, parental mental health history, and SES in childhood with opioid analgesic prescription patterns nationwide in Sweden. Using register-based data, we identified 5,071,193 (48.4% female) adolescents and adults who were naive to prescription opioid analgesics and followed them from 2007 to 2014. The cumulative incidence of any dispensed opioid analgesic within 3 years was 11.4% (95% CI, 11.3%-11.4%). Individuals with preexisting self-injurious behavior, as well as opioid and other substance use, attention-deficit/hyperactivity, depressive, anxiety, and bipolar disorders had greater opioid therapy initiation rates than did individuals without the respective conditions (hazard ratios from 1.24 [1.20-1.27] for bipolar disorder to 2.12 [2.04-2.21] for opioid use disorder). Among 1,298,083 opioid recipients, the cumulative incidence of long-term opioid therapy (LTOT) was 7.6% (7.6%-7.7%) within 3 years of initiation. All mental health conditions were associated with greater LTOT rates (hazard ratios from 1.66 [1.56-1.77] for bipolar disorder to 3.82 [3.51-4.15] for opioid use disorder) and were similarly associated with concurrent benzodiazepine-opioid therapy. Among 1,482,462 adolescents and young adults, initiation and LTOT rates were greater for those with parental mental health history or lower childhood SES. Efforts to understand and ameliorate potential adverse effects of opioid analgesics must account for these patterns.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Beroendelära hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Substance Abuse hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
Adverse selection
Pharmacoepidemiology
Prescription opioid analgesics
Psychiatric conditions

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Rickert, Martin E.Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States (author)
Franck, JohanKarolinska Institutet (author)
Sariaslan, AmirKarolinska Institutet (author)
Boersma, Katja,professor,1973-Örebro universitet,Institutionen för juridik, psykologi och socialt arbete,Center for Health and Medical Psychology (CHAMP)(Swepub:oru)kba (author)
Lichtenstein, PaulKarolinska Institutet (author)
Larsson, Henrik,1975-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden(Swepub:oru)hiln (author)
DʼOnofrio, Brian M.Karolinska Institutet (author)
Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United StatesDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States (creator_code:org_t)

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In:Pain: Elsevier160:11, s. 2464-24720304-39591872-6623

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