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Cohort study
Among opioid-naive patients receiving opioids, more intensive opioid prescribing in the first month is associated with transition to long-term opioid use
  1. Marc R Larochelle
  1. Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Marc R Larochelle, Boston Medical Center, Section of General Internal Medicine, Crosstown Center 2nd Floor, 801 Massachusetts Avenue, Boston MA 02118, USA; marc.larochelle{at}

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Commentary on: Deyo RA, Hallvik SE, Hildebran C, et al. Association between initial opioid prescribing patterns and subsequent long-term use among opioid-naïve patients: a statewide retrospective cohort study. J Gen Intern Med 2017;32(1):21-7.


A recent systematic review of long-term opioid use for chronic pain found that evidence is lacking to support benefit from long-term opioid therapy, and evidence supports a dose-dependent risk of opioid-related harms including overdose and death.1 Despite the evidence, an estimated 5 to 8 million Americans receive long-term opioid therapy.2 Understanding the transition from acute or episodic use of opioids to long-term opioid use may help design interventions to reduce the incidence of long-term opioid use. This study sought to analyse the association between prescribing patterns in the first 30 days of opioid receipt among formerly opioid-naive subjects and transitioning to long-term opioid use. …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.