Journal of General Internal Medicine

, Volume 29, Issue 3, pp 429–431 | Cite as

SMART Designs in Observational Studies of Opioid Therapy Duration

  • John W. Jackson
  • Joshua J. GagneEmail author

Chronic pain affects around 100 million US adults and is associated with $635 billion in annual direct and lost productivity costs.1 With the growing acceptance of palliative treatment for pain, prescription opioid use has risen dramatically over the past decade.2 Hydrocodone plus acetaminophen is the most commonly prescribed drug in the US.3 Though effective in relieving pain, long-term opioid therapy has been linked to many safety concerns, including substance abuse, fractures, premature labor and neonatal abstinence syndrome, and deaths from accidental overdose.2

In this issue of JGIM, Scherrer and colleagues add to the litany of potential adverse events associated with long-term opioid use. Using propensity-score methods and administrative billing records, including medical encounter and prescription dispensing data from the Veterans Administration health care system (VA), the authors investigated whether duration of prescription opioid use was associated with increased risk of...


Propensity Score Veteran Administration Health Prescription Opioid Opioid Therapy Veteran Administration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  1. 1.Division of Pharmacoepidemiology and Pharmacoeconomics, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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