Evidence mapPaperPMID 33400442Full record

ArticlePain physician2021

Prescription Opioid Use and Laboratory Value Derangements: A Cross-Sectional Analysis of NHANES Data.

Micah Hartwell, Benjamin Greiner, Kelly Dunn, Julie Croff, Jason Beaman

Open access · bronzeAbstract read
In one paragraph

Article in Pain physician, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Micah HartwellDepartment of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK.
Benjamin GreinerOklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Tulsa, OK.
Kelly DunnDepartment of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK; Oklahoma State University Center for Health Sciences, National Center for Wellness and Recovery, Tulsa, OK.
Julie CroffOklahoma State University Center for Health Sciences, National Center for Wellness and Recovery, Tulsa, OK.
Jason BeamanDepartment of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK; Oklahoma State University Center for Health Sciences, National Center for Wellness and Recovery, Tulsa, OK.
Oklahoma State University Center for Health Sciences · US

Funding

Linking Daily Parental PACEs to Parenting and Preschoolers' Self-Regulation Growth: A Burst-Design Longitudinal StudyP20GM109097 · OSU CENTER FOR HEALTH SCIENCES · 2025 to 2025
$1.9M
10/24 Healthy Brain and Child Development National ConsortiumU01DA055349 · OSU CENTER FOR HEALTH SCIENCES · 2025 to 2025
$1.3M
NIDA NIH HHS R34 DA050343NIDA NIH HHS U01 DA055349NIGMS NIH HHS P20 GM109097
6 · The paper itself

Abstract

backgroundThe use of opioids for the treatment of pain is a risk versus benefit analysis and metabolic disease is an often overlooked variable in the equation and may lead to increased risk of comorbidities of cardiovascular and cerebrovascular disease and diabetes.

objectivesOur objective was to identify and describe abnormalities among the comprehensive metabolic and lipid panels of individuals taking prescription opioids. STUDY

designWe performed a cross-sectional study of the laboratory values with 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES) in March 2020.

settingNHANES sampling is conducted using a multistaged, stratified, cluster sampling technique to create a representative sample of the United States.

methodsWe excluded patients with histories of cancer and under the age of 25 years. Our final sample size was 11,061 (n = 162,547,635), with 797 reportedly using a prescription opioid in the past 30 days-a weighted percent representing 22.95% of the US population. Our analyses identified mean differences in biomarkers between individuals taking prescription opioids and the US population.

resultsLaboratory values from the comprehensive metabolic panel were all within reference ranges for both groups, with only bilirubin levels being statistically lower in the group currently taking prescription opioids. Values from the lipid panel of both the opioid using and comparison groups were above reference range for total cholesterol and fasting glucose. The opioid using group was also higher than the reference range for triglycerides (mean [M] = 165.4, standard deviation [SD] = 14.2) and insulin (M = 15.5, SD = 2.2), whereas the comparison group was not.  The oral glucose measure was within normal ranges for both groups; however, the opioid using group was 13.7 points higher than the comparison group (M = 122.3, SD = 1.8; M = 108.6, SD = 4.0; P < 0.01). LIMITATIONS: While our study uses a large sample for a robust generalizable analysis it is a correlation study and a longitudinal cohort would provide better evidence linking potential disease states to prescription opioid use.

conclusionsAlthough all Americans should be alarmed at the lipid levels reported in this study, specific combinations of heightened lipid laboratory values among prescription opioid users accelerate the trajectories toward comorbidities-heart disease, cerebrovascular disease, and diabetes-leading to diminished quality of life. Therefore pain management and comprehensive drug recovery programs should include nutritional counseling and physical activity as part of their overall treatment plan.

Indexed as

AdultAnalgesics, OpioidBlood GlucoseCholesterolCohort StudiesCross-Sectional StudiesFemaleHumansMaleMiddle AgedNutrition SurveysTriglyceridesUnited StatesAnalgesics, OpioidBlood GlucoseCholesterolTriglyceridesanalgesicslab valuesNHANESOpioid usepain management

Identifiers

PMID33400442
PMCPMC9810267
OpenAlexW3120927785

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.