Impacts of Initial Prescription Length and Prescribing Limits on Risk of Prolonged Postsurgical Opioid Use

*Department of Epidemiology, Gillings School of Global Public Health

†Cecil G. Sheps Center for Health Services Research

‡Injury Prevention Research Center, University of North Carolina at Chapel Hill

§Department of Anesthesiology and Pain Management, University of North Carolina School of Medicine

∥Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC

Presented as a virtual oral presentation at ICPE All Access, taking place September 16, 2020–September 17, 2020.

Partially supported by a National Research Service Award Pre-Doctoral/Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality sponsored by The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Grant No. T32-HS000032.

The database infrastructure used for this project was funded by the Pharmacoepidemiology Gillings Innovation Lab (PEGIL) for the Population-Based Evaluation of Drug Benefits and Harms in Older US Adults (GIL200811.0010), the Center for Pharmacoepidemiology, Department of Epidemiology, UNC Gillings School of Global Public Health, the CER Strategic Initiative of UNC’s Clinical Translational Science Award (UL1TR002489), the Cecil G. Sheps Center for Health Services Research, UNC, and the UNC School of Medicine.

J.C.Y. received tuition and stipend support from NIH/NIDA R36 DA04588501 (PI: Young). N.D. is supported by the US Food and Drug Administration (HHSF223201810183C). He does not accept personal compensation of any kind from any pharmaceutical company. T.S. receives investigator-initiated research funding and support as Principal Investigator (R01 AG056479) from the National Institute on Aging (NIA) and as Co-Investigator (R01 HL118255, R01MD011680), National Institutes of Health (NIH). He also receives salary support as Director of Comparative Effectiveness Research (CER), NC TraCS Institute, UNC Clinical and Translational Science Award (UL1TR002489), the Center for Pharmacoepidemiology (current members: GlaxoSmithKline, UCB BioSciences, Takeda, AbbVie, Boehringer Ingelheim), from pharmaceutical companies (Novo Nordisk), and from a generous contribution from Dr. Nancy A. Dreyer to the Department of Epidemiology, University of North Carolina at Chapel Hill. He does not accept personal compensation of any kind from any pharmaceutical company. M.J.F. receives investigator-initiated research funding support as Principal Investigator from the US Food and Drug Administration (FDA: 75F40119C10115) and the National Heart, Lung, and Blood Institute (NHLBI: R01 HL118255), and as Co-investigator from the FDA (CER-2017C3-9230), Centers for Disease Control and Prevention (CDC: 1U01DP006369-01), National Center for Advancing Translational Sciences (NCATS: 1 U54 TR002255), National Institute on Aging (NIA: 1R01AG056479), and Health Resources & Services Administration (HRSA: R40MC29455-01-00). She additionally receives salary support from the Center for Pharmacoepidemiology in the Department of Epidemiology, UNC (members: GlaxoSmithKline, UCB BioSciences, Merck (past member), Takeda, Abbvie, Boehringer Ingelheim), and consulting fees via UNC from GlaxoSmithKline. J.C.Y. receives consulting fees from CERobs Consulting LLC. T.S. and M.J.F. receive salary support via UNC from the Center for Pharmacoepidemiology [members: GlaxoSmithKline, UCB BioSciences, Merck (past member), Takeda, Abbvie, Boehringer Ingelheim]. T.S. owns stock in Novartis, Roche, BASF, AstraZeneca, and Novo Nordisk. M.J.F. receives consulting fees via UNC from GSK. N.D. is a consultant to the RADARS System of Denver Health and Hospital Authority, a political subdivision of the State of Colorado (USA). The remaining authors declare no conflict of interest.

Correspondence to: Jessica C. Young, MSPH, PhD, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599-7400. E-mail: [email protected].

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