High Opioid Doses Raise Risk of Overdose in Chronic Pain Patients
Michael Von Korff, ScD, a senior investigator at Group Health Research Institute, and colleagues examined about 10,000 patients who had been given multiple opioid prescriptions for chronic pain conditions. Those who were given higher doses of opioids were nine times more likely to overdose than those who were given lower doses. However, most overdoses occurred among those who received low to medium doses, as those prescriptions were much more common.
According to the Centers for Disease Control and Prevention, about 3 percent of U.S. adults use opioids for chronic pain. In 2006, about 14,000 deaths involved prescription opioids, more than three times the number of opioid-related deaths in 1999.
Dr. Von Korff said that while some studies suggest that fatal opioid overdoses occur mostly among those abusing prescription drugs or obtaining them from non-medical sources, their study suggests that many occur among people using prescribed opioids for chronic pain. He added that physicians should carefully evaluate and monitor patients using opioids in the long term.
They found that opioid overdose occurred at similar rates among all ages. While suicide attempts and drug abuse were noted only in some of the overdoses, opioid overdoses appeared to be more frequent among those with a history of substance abuse or depression.
Study co-author Bruce M. Psaty, MD, PhD, a senior investigator at Group Health Research Institute and a professor of medicine, epidemiology, and health services at the University of Washington, said that opioids are widely prescribed long-term for many people with chronic pain, so more careful prescribing is necessary.
Source: Science Daily, Higher Opioid Dose Linked to Overdose Risk in Chronic Pain Patients, January 19, 2010