Abstract | BACKGROUND AND OBJECTIVES: METHODS: We conducted an active comparator cohort study spanning 2000 to 2019 using healthcare utilization data from 4 US commercial and public insurance databases. Individuals were required to have at least 180 days of continuous enrollment and at least 90 days of continuous prescription opioid use immediately before and on the date of skeletal muscle relaxant initiation. Exposures were the concomitant use of prescription opioids and skeletal muscle relaxants, and the main outcome was the hazard ratio (HR) and bootstrapped 95% CI of opioid overdose resulting in an emergency department visit or hospitalization. The primary analysis quantified opioid overdose risk across 7 prescription opioid-skeletal muscle relaxant therapies and a negative control outcome ( sepsis) to assess potential confounding by unmeasured illicit opioid use. Secondary analyses evaluated two-group and five-group comparisons in patients with similar baseline characteristics; individuals without previous recorded substance abuse; and subgroups stratified by baseline opioid dosage, benzodiazepine codispensing, and oxycodone or hydrocodone use. RESULTS: DISCUSSION:
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Authors | Nazleen F Khan, Katsiaryna Bykov, Michael L Barnett, Robert J Glynn, Seanna M Vine, Joshua J Gagne |
Journal | Neurology
(Neurology)
Vol. 99
Issue 13
Pg. e1432-e1442
(09 27 2022)
ISSN: 1526-632X [Electronic] United States |
PMID | 35835561
(Publication Type: Journal Article)
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Copyright | © 2022 American Academy of Neurology. |
Chemical References |
- Analgesics, Opioid
- Narcotic Antagonists
- Neuromuscular Agents
- Methocarbamol
- Benzodiazepines
- Amitriptyline
- Carisoprodol
- cyclobenzaprine
- Hydrocodone
- Orphenadrine
- Oxycodone
- Chlorzoxazone
- Baclofen
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Topics |
- Amitriptyline
(analogs & derivatives)
- Analgesics, Opioid
- Baclofen
- Benzodiazepines
(adverse effects)
- Carisoprodol
- Chlorzoxazone
- Cohort Studies
- Humans
- Hydrocodone
- Methocarbamol
- Narcotic Antagonists
(therapeutic use)
- Neuromuscular Agents
(adverse effects)
- Opiate Overdose
- Orphenadrine
- Oxycodone
- Prescriptions
- Sepsis
(drug therapy)
- Substance-Related Disorders
(drug therapy)
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