Evidence map›Paper›PMID 41837952›Full record

ArticlePain2026

Change in prescription opioid dose and the risk of mental health-related and substance use-related emergency department presentations: a case-crossover study.

Monica Jung, Ting Xia, Louisa Picco, Dan I Lubman, Samanta Lalic, Christopher Pearce, Rachelle Buchbinder, Bosco Rowland, Nadine E Andrew, J Simon Bell and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Monica JungMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0001-6458-1279
Ting XiaMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0001-5033-6248
Louisa PiccoMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0001-7593-3209
Dan I LubmanMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0002-6747-1937
Samanta LalicPharmacy Department, Monash Health, Melbourne, Australia.ORCID 0000-0002-7055-3626
Christopher PearceOutcome Health, Melbourne, Australia.ORCID 0000-0002-3132-6033
Rachelle BuchbinderMusculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.ORCID 0000-0002-0597-0933
Bosco RowlandMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0003-0192-809
Nadine E AndrewPeninsula Clinical School, School of Translational Medicine, Monash University, Melbourne, Australia.ORCID 0000-0002-4846-2840
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.ORCID 0000-0002-6115-2767
Suzanne NielsenMonash Addiction Research Centre, Eastern Clinical School, Monash University, Melbourne, Australia.ORCID 0000-0001-5341-1055

Funding

National Health and Medical Research Council 1194483National Health and Medical Research Council 1196892National Health and Medical Research Council 2016909National Health and Medical Research Council 2025894National Health and Medical Research Council GNT2002193
6 · The paper itself

Abstract

abstractOpioid deprescribing is recommended to reduce opioid-related harms; however, research suggests that opioid dose changes may lead to adverse health outcomes. We aimed to determine if opioid dose changes are associated with mental health-related or substance use-related emergency department (ED) presentations. This self-controlled case-crossover study used POpulation Level Analysis and Reporting (POLAR) primary care data linked with data from 3 metropolitan hospitals in Victoria, Australia. People who had a mental health-related or substance use-related ED (MHSU-ED) presentation between April 2018 and May 2022 and had received ≥4 opioid prescriptions in the 12 months preceding their ED presentation were included. Adjusted odds ratios (aOR) for MHSU-ED presentations were estimated using conditional logistic regression, comparing opioid dose change in the 30 days before MHSU-ED presentation to that in 5 corresponding sets of control periods of equal length not immediately preceding MHSU-ED presentation. Of the 1458 eligible patients, 75.9% experienced a >25% reduction in their prescribed opioid dose in the 30 days before MHSU-ED presentation. Compared with receiving no opioid prescriptions in the 30 days prior, a >25% reduction in prescribed opioid dose (aOR: 1.78; 95% confidence interval [CI]: 1.44-2.21) or opioid discontinuation (aOR: 2.04; 95% CI: 1.48-2.82) was linked to higher odds of a MHSU-ED presentation whilst a 10% to 25% reduction (aOR: 0.15; 95% CI: 0.10-0.23) or a stable or increased dose (aOR: 0.01; 95% CI: 0.008-0.022) was associated with lower odds of MHSU-ED presentation. Larger opioid dose reduction or discontinuation is associated with increased risk of subsequent mental health-related and substance use-related ED presentations.

Indexed as

Analgesics, OpioidEmergency Service, HospitalMental DisordersOpioid-Related DisordersSubstance-Related DisordersAdultCase-Control StudiesCross-Over StudiesFemaleHumansMaleMiddle AgedVictoriaYoung AdultAnalgesics, OpioidEmergency department presentationsMental healthOpioid analgesicsOpioid-related harmsPsychotropic medicinesSubstance use

Identifiers

PMID41837952
PMCPMC12994512

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.