Opioid addiction is a serious public health concern that affects millions of people worldwide. Compulsive use of opioids is described despite negative consequences such as health problems, relationship problems, and financial problems. Addiction can be caused by a variety of factors, including chronic illness, mental health issues, and exposure to opioid medications.
Discontinuing opioid therapy for pain increases the risk of overdose in patients.
Opioid-related overdoses are a major contributor to sudden deaths in the United States and Canada. A new study recently published in the journal PLOS MedicineDr. Mary Claire Kennedy of Kelowna, British Columbia, Canada, indicates that stopping prescribed opioids increases the risk of overdose.
Canada and the United States have developed guidelines that limit opioid prescriptions for chronic pain in an effort to reduce opioid-related morbidity and mortality. However, the effect of discontinuing opioid therapy on the risk of overdose is largely unstudied. A team of researchers conducted a retrospective study of individuals receiving long-term opioid therapy in British Columbia between October 2014 and June 2018 to examine the relationship between discontinuation of prescribed opioid therapy for pain and overdose risk. They studied medical records. In British Columbia, 14,037 patients who had been on opioid therapy for at least 90 days were enrolled in the provincial health insurance client list.
The researchers found that stopping opioid treatment for pain was associated with an increased risk of overdose in people without opioid use disorder (OUD). However, the association was stronger in those with OUD, including those not receiving opioid agonist therapy (AHR = 3.18; 95% CI = 1.87 – 5.40, p<0.001) and receiving opioid agonist therapy (AHR = 2.52; 95% CI = 1.68 -). 3.78, p<0.001). Finally, recording opioid therapy was associated with a reduced risk of overdose for those who did not receive opioid agonist therapy (AHR = 0.31, 95% CI = 0.14 - 0.67, p=0.003).
The study had several limitations, as the results of the study did not include non-health care related or fatal overdose events. In addition, the researchers were unable to determine the source of the overdose-related drugs and whether they were prescribed or obtained illegally.
According to the authors, “These findings indicate the need to improve guidelines for physicians to avoid abrupt discontinuation of opioid therapy for pain and to improve strategies for tapering opioid therapy based on opioid use disorder and opioid agonist treatment status.”
Kennedy added, “Given the risk of overdose, abrupt discontinuation of opioid therapy for chronic pain should be avoided in almost all cases.” Improved guidance is needed to implement safe and effective opioid-based pain management strategies, specifically considering opioid use disorder and the status of prescribed opioid agonist therapy.
Reference: “Discontinuation of Prescription Opioids and Risk of Overdose Among People Taking Long-Term Opioid Treatment for Painful and Non-Opioid Use Disorder in British Columbia, Canada: By Mary Claire Kennedy, Alexis Crabattre, Seanide Nolan to A retrospective cohort study, Wing Yin Mok, Zishan Cui, Mei Chong, Amanda Sloughwhite and Lianping T, 1 Dec 2022; PLOS Medicine.
DOI: 10.1371/journal.pmed.1004123
This study was funded by a Canadian Health Research Project Grant. SN is supported by the Michael Smith Foundation for Health Research and the Steven Diamond Professorship in Innovation in Addiction Care at the University of British Columbia. LT is supported by a Michael Smith Foundation for Health Research Scholar Award. The funders had no role in study design, data collection and analysis, decision to publish, and preparation of the manuscript.
[ad_2]