2019
High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans.
Banerjee G, Edelman EJ, Barry DT, Crystal S, Gordon KS, Gordon AJ, Gaither JR, Green TC, Kerns RD, Manhapra A, Moore BA, Fiellin DA, Marshall BDL. High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans. Pain 2019, 160: 2126-2135. PMID: 31145217, PMCID: PMC6699915, DOI: 10.1097/j.pain.0000000000001606.Peer-Reviewed Original ResearchConceptsHigh-dose opioid prescriptionsOpioid prescriptionsHeroin useCohort studyPrior receiptHepatitis C virus (HCV) infection statusLong-term opioid prescriptionsPast-year heroin useVeterans Aging Cohort StudyHigh-dose opioidsOpioid-prescribing patternsProspective cohort studyAging Cohort StudyOpioid use disorderCurrent national guidelinesUnhealthy alcohol useUnited States veteransUnited States military veteransVirus infection statusPosttraumatic stress disorderOpioid receiptPrescribed opioidsPain interferenceCox regressionStates veterans
2018
Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care
Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018, 19: s54-s60. PMID: 30203014, DOI: 10.1093/pm/pny114.Peer-Reviewed Original ResearchConceptsOEF/OIF/OND veteransOpioid prescriptionsChiropractic visitsOpioid useChiropractic careOperations Enduring Freedom/Iraqi Freedom/New DawnMore opioid prescriptionsVA chiropractic servicesPercentage of veteransCross-sectional analysisOpioid receiptClinic visitsClinical characteristicsCurrent smokingSevere painChiropractic clinicChiropractic servicesVisitsHigher likelihoodVeteransPrescriptionCareFurther studiesAdministrative dataOne-thirdDuration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care
Barry DT, Marshall BDL, Becker WC, Gordon AJ, Crystal S, Kerns RD, Gaither JR, Gordon KS, Justice AC, Fiellin DA, Edelman EJ. Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug And Alcohol Dependence 2018, 191: 348-354. PMID: 30176548, PMCID: PMC6596307, DOI: 10.1016/j.drugalcdep.2018.07.008.Peer-Reviewed Original ResearchConceptsPrescription opioid receiptPrescription opioidsMedical careOpioid receiptVeterans Health Administration primary careNonmedical useMultivariable Cox modelInfectious disease clinicProspective cohort studyProportional hazards regressionPrescription opioid medicationsPublic health problemSubstance use disordersMedication-related characteristicsOpioid therapyOpioid medicationsOpioid prescriptionsCohort studyDisease clinicMedian ageHazards regressionEligible participantsPrimary careRisk factorsIncidence rate
2017
Impact of the Opioid Safety Initiative on opioid-related prescribing in veterans
Lin LA, Bohnert ASB, Kerns RD, Clay MA, Ganoczy D, Ilgen MA. Impact of the Opioid Safety Initiative on opioid-related prescribing in veterans. Pain 2017, 158: 833-839. PMID: 28240996, DOI: 10.1097/j.pain.0000000000000837.Peer-Reviewed Original ResearchConceptsOpioid Safety InitiativeVeterans Health AdministrationConcurrent benzodiazepineDaily opioid dosageElectronic medical record dataOutpatient opioid prescriptionsSafe opioid prescribingOpioid prescribing practicesMedical record dataInterrupted time series analysisSafety initiativesOpioid dosageOpioid prescribingOpioid prescriptionsOpioid regimensOutpatient prescribingVHA patientsPrescribing practicesVHA facilitiesAdverse outcomesSafe prescribingSystem-wide initiativesPrescribingPatientsOpioids
2016
Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
Bastian LA, Driscoll MA, Heapy AA, Becker WC, Goulet JL, Kerns RD, DeRycke EC, Perez E, Lynch SM, Mattocks K, Kroll-Desrosiers AR, Brandt CA, Skanderson M, Bathulapalli H, Haskell SG. Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars. Pain Medicine 2016, 18: 1089-1097. PMID: 27659441, DOI: 10.1093/pm/pnw223.Peer-Reviewed Original ResearchConceptsCurrent pain intensityOpioid prescriptionsPain intensitySmoking statusOEF/OIF/OND veteransCurrent smokersFormer smokersOpioid useVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnMild pain intensityMore opioid prescriptionsSevere pain intensityNumeric rating scalePrimary care clinicsCigarette smoking statusCross-sectional analysisOpioid receiptFormer smokingCohort studyCurrent smokingCare clinicsChronic painCigarette smokersSmoking cessationPrevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer.
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer. Journal Of Opioid Management 2016, 12: 259-68. PMID: 27575827, DOI: 10.5055/jom.2016.0341.Peer-Reviewed Original ResearchConceptsPrescription opioid useVeterans Health Administration patientsOpioid useMetastatic cancerAnxiolytic medicationMedical indicationsMultivariate analysisMore emergency department visitsNational VHA dataEmergency department visitsPrescription of antidepressantsAnxiolytic prescriptionsOpioid prescriptionsDepartment visitsVHA patientsPsychotropic medicationsFiscal year 2012VHA dataDrug AdministrationMedicationsBipolar disorderCareful monitoringYounger ageAnxiolyticsCancerNational Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use
Ducoffe AR, York A, Hu DJ, Perfetto D, Kerns RD. National Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use. Pain Medicine 2016, 17: 2291-2304. PMID: 28025363, PMCID: PMC6280931, DOI: 10.1093/pm/pnw106.Peer-Reviewed Original ResearchConceptsAdverse drug eventsAdverse drug event preventionOpioid useEvent preventionOutpatient opioid prescriptionsOutpatient opioid useSafe opioid usePublic health challengeEvidence-based preventionADE preventionOpioid prescriptionsHealthcare delivery settingsDiabetes agentsDrug eventsDrug classesHealth promotionHealthcare providersDisease preventionHealth challengesPatient safetyDelivery settingsPreventionNational Action PlanAction planAdditional researchAssociation between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans
Burgess DJ, Gravely AA, Nelson DB, Bair MJ, Kerns RD, Higgins DM, Farmer MM, Partin MR. Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans. The Journal Of Rehabilitation Research And Development 2016, 53: 13-24. PMID: 26933921, DOI: 10.1682/jrrd.2014.10.0252.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyIndex visitOpioid prescriptionsPain outcomesCohort studyMusculoskeletal painPain treatmentPain interferenceBenefits of opioidsElectronic medical record dataGreater pain interferencePharmacologic pain treatmentsChronic noncancer painVeterans Affairs patientsChronic musculoskeletal painMedical record dataNoncancer painOpioid treatmentMost patientsVA patientsVA SurveyAlternative treatmentPatientsSignificant associationPain
2015
Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression
Sellinger JJ, Sofuoglu M, Kerns RD, Rosenheck RA. Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression. Psychiatric Quarterly 2015, 87: 585-593. PMID: 26646578, DOI: 10.1007/s11126-015-9411-1.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationMusculoskeletal painAntidepressant useVeterans Health Administration dataAnnual opioid prescriptionsNational VHA databasesUse of antidepressantsCo-morbid depressionTreatment of painHealth Administration dataMajor depressive disorderNon-depressed groupOpioid therapyAnalgesic benefitOpioid prescribingOpioid prescriptionsPrescribing patternsOpioid useVHA databasesFiscal year 2012Depressive disorderDepression diagnosisPainAntidepressantsOpioidsReceipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care
Kroll-Desrosiers AR, Skanderson M, Bastian LA, Brandt CA, Haskell S, Kerns RD, Mattocks KM. Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care. Women's Health Issues 2015, 26: 240-246. PMID: 26549242, DOI: 10.1016/j.whi.2015.09.010.Peer-Reviewed Original ResearchConceptsPrescription opioid usePregnancy windowsOpioid prescriptionsPsychiatric diagnosisWomen veteransPregnant veteransOpioid usePrescription opioidsVeterans Health Administration (VHA) careMultivariable logistic regression modelVeterans Health Administration (VHA) servicesNontraumatic joint disordersPain management strategiesHealth-related variablesLogistic regression modelsPhysical health variablesPotential undertreatmentVHA servicesJoint disordersVHA systemOperation Enduring FreedomBack problemsOpioidsHealth variablesNational databaseTrends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original ResearchPrevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration. Psychiatry Research 2015, 227: 324-332. PMID: 25863822, DOI: 10.1016/j.psychres.2015.03.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Anxiety AgentsAntidepressive AgentsDrug PrescriptionsFemaleHumansHypnotics and SedativesMaleMental DisordersOpioid-Related DisordersPrevalencePsychotropic DrugsSleep Initiation and Maintenance DisordersUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsMental health clinicsPsychotropic medicationsOpioid prescriptionsHealth clinicsMedical indicationsAnxiolytics/sedatives/hypnoticsLong-term opioid useSpecialty mental health clinicsService use correlatesRelated adverse eventsSedative/hypnoticsVeterans Health AdministrationMental health treatmentAdverse eventsOpioid useHarmful side effectsFiscal year 2012More psychotropicsSide effectsPsychiatric diagnosisHealth treatmentMedicationsHealth AdministrationPsychotropicsAnxiety disorders
2014
Racial Differences in Prescription of Opioid Analgesics for Chronic Noncancer Pain in a National Sample of Veterans
Burgess DJ, Nelson DB, Gravely AA, Bair MJ, Kerns RD, Higgins DM, van Ryn M, Farmer M, Partin MR. Racial Differences in Prescription of Opioid Analgesics for Chronic Noncancer Pain in a National Sample of Veterans. Journal Of Pain 2014, 15: 447-455. PMID: 24440840, DOI: 10.1016/j.jpain.2013.12.010.Peer-Reviewed Original ResearchConceptsChronic noncancer painPain intensity ratingsPrescription of opioidsNoncancer painOpioid prescriptionsRacial differencesVeterans Affairs Health Care SystemIntensity ratingsElectronic medical record dataRetrospective cohort studyPain intensity scoresPrimary care patientsMedical record dataYears of agePossible racial differencesHealth care facilitiesSignificant racial differencesSystem-level factorsHealth care systemPatients 65Cohort studyJoint painPatient ageCare patientsOpioid analgesics
2012
Receipt of Opioid Analgesics by HIV-Infected and Uninfected Patients
Edelman EJ, Gordon K, Becker WC, Goulet JL, Skanderson M, Gaither JR, Brennan Braden J, Gordon AJ, Kerns RD, Justice AC, Fiellin DA. Receipt of Opioid Analgesics by HIV-Infected and Uninfected Patients. Journal Of General Internal Medicine 2012, 28: 82-90. PMID: 22895747, PMCID: PMC3539026, DOI: 10.1007/s11606-012-2189-z.Peer-Reviewed Original ResearchConceptsLong-term opioidsHigh-dose opioidsUninfected patientsOpioid receiptHIV statusPain diagnosisHIV infectionVeterans Aging Cohort StudyVeterans Health Administration (VHA) careDaily morphine equivalent doseAcute pain diagnosisDays of opioidsMorphine equivalent doseAging Cohort StudyDesignCross-sectional analysisChronic pain diagnosesICD-9 codesVulnerable patient populationAverage daily doseMorphine equivalentsOpioid prescriptionsCohort studyDaily doseOpioid analgesicsPain management
2011
Nonmedical use of prescription opioids and pain in veterans with and without HIV
Barry DT, Goulet JL, Kerns RK, Becker WC, Gordon AJ, Justice AC, Fiellin DA. Nonmedical use of prescription opioids and pain in veterans with and without HIV. Pain 2011, 152: 1133-1138. PMID: 21354703, PMCID: PMC3086805, DOI: 10.1016/j.pain.2011.01.038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidChi-Square DistributionCohort StudiesFemaleHealth SurveysHIV InfectionsHumansLogistic ModelsMaleMental DisordersMiddle AgedOdds RatioOpioid-Related DisordersPainPain MeasurementPrescriptionsPsychiatric Status Rating ScalesRetrospective StudiesSelf ReportSurveys and QuestionnairesVeterans HealthYoung AdultConceptsHuman immunodeficiency virusPrescription opioidsComponent summaryHIV statusPain interferenceUse disordersForm Health Survey Mental Component SummarySF-12 Physical Component SummaryVeterans Aging Cohort StudyNonmedical usePharmacy record dataAlcohol Use Disorders Identification Test (AUDIT) scoresAging Cohort StudyPhysical component summaryMental component summaryOpioid use disorderMedian participant ageDrug use disordersLegitimate medical reasonsPast-month cigarette useChi-squared testU.S. military veteransHepatitis COpioid prescriptionsCohort study