Abstract
PURPOSE: To assess the 1‐year risk of fall‐related injuries among new users of opioids in Denmark. METHODS: Using Danish health registers, we identified all new adult users of opioids between 2010 and 2022 (first time use within 5 years). We performed logistic regression and applied marginal comparisons to estimate risk ratios (RRs) associating baseline risk factors to any fall‐related injury and fall‐related fractures specifically. Patients were followed after opioid initiation until fall‐related injury, death, leaving the country, or 1‐year follow‐up, whichever occurred first. RESULTS: We identified 1 638 358 unique new users of opioids (54% women; median age 58 years). The 1‐year risk of fall‐related injuries and fall‐related fractures was 8.6% and 3.6%, respectively. The risk of fall‐related injuries was highest during the first weeks following opioid initiation. Increasing age, depression, Parkinson's disease, osteoporosis, and prior fall‐related injuries were all associated with new fall‐related injuries in the multivariable analysis. Prior fall‐related injuries was a predictor of new fall‐related injuries (RR 2.15; 95% CI: 2.12–2.18) and fall‐related fractures (RR 1.35; 95% CI: 1.31–1.40). Prior fall‐related fractures was a predictor of new fall‐related injuries (RR 1.96; 95% CI: 1.93–1.99) and fall‐related fractures (RR 6.47; 95% CI: 6.29–6.65). CONCLUSION: The 1‐year risk for any fall‐related injuries and fractures was 8.6% and 3.6%, respectively, and highest in the first weeks following opioid initiation. Several important risk factors associated with new fall‐related injuries were identified. Physicians should be aware of patient characteristics related to fall risk when prescribing opioids.