Can opioid and sedative orders months apart establish co-use?

The study counted orders in calendar windows

Hartung and colleagues examined prescription orders in a network of safety-net community health centers from 2009 to 2018. For each six-month calendar period, they classified a patient as co-prescribed if the record contained both an opioid order and a sedative-hypnotic order. The latter category included benzodiazepines and medicines such as zolpidem.

Calendar overlap and drug exposure differ

An order in January and another in June can fall in the same window even when the courses never overlap. A course spanning the boundary between windows can also affect how a patient is classified. The order data did not establish if or when refills were dispensed.

Which timeline fits the legal question?

For a particular incident, look for fills, days supplied and records of doses actually taken or administered. The six-month definition is useful for studying prescribing patterns across a clinic network. It cannot establish simultaneous exposure at the time of a specific event.

Source paper

Hartung et al., Journal of Primary Care & Community Health (2023) · Full text