Discontinuing opioid remedy for ache could enhance the chance of overdose in sufferers.
Opioid-related overdoses have turn into a serious contributor to unintentional deaths in the US and Canada. A brand new examine just lately printed within the journal PLOS medicationLed by Marie Claire Kennedy College of British Columbiakelowna, canada signifies that stopping prescribed opioids could enhance the chance of overdose.
In an effort to scale back opioid-related deaths and diseases, Canada and the US have established pointers to scale back opioid prescriptions for persistent ache. Nonetheless, the impact of discontinuing opioid therapies on overdose danger stays largely unstudied. To research the connection between discontinuing prescribed opioid remedy for ache and danger of overdose, a group of researchers carried out a retrospective cohort examine of people receiving long-term opioid remedy for ache in British Columbia between October 2014 and June 2018. They examined medical information for ache. 14,037 sufferers had been enrolled within the British Columbia Provincial Well being Insurance coverage consumer listing who had been receiving opioid remedy for a minimum of 90 days.
Researchers discovered that discontinuing opioid remedy for ache was related to an elevated danger of overdose amongst individuals with out opioid use dysfunction (OUD). Nonetheless, the affiliation was strongest in these with OUD, together with these not receiving opioid agonist remedy (AHR = 3.18; 95% CI = 1.87–5.40, p < 0.001) and receiving opioid remedy (AHR = 2.52; 95). %CI = 1.68 - 3.78, p < 0.001). Lastly, lowering opioid remedy was related to a decreased danger of overdose in these with OUD who didn't obtain opioid agonist remedy (AHR = 0.31, 95% CI = 0.14–0.67, p = 0.003).
The examine had a number of limitations as a result of the end result measure didn’t seize overdose occasions that didn’t contain a healthcare encounter or result in demise. Moreover, the researchers had been unable to find out the supply of the medication implicated within the overdose and whether or not they had been prescribed or obtained illegally.
In response to the authors, “These findings recommend the necessity to keep away from abrupt discontinuation of opioid remedy for ache and to boost steerage for prescribers in adjusting opioid remedy methods primarily based on opioid use dysfunction and opioid remedy standing.”
Kennedy provides: “Due to the elevated danger of overdose, abrupt discontinuation of opioid remedy for persistent ache must be averted in virtually all instances. Improved steerage is required to help prescribers in implementing secure and efficient ache discount methods, with particular consideration for opioid use dysfunction and situation on opioid agonist remedy.” described”.
Reference: “Stopping and lowering prescription opioid analgesics and the chance of overdose amongst topics receiving long-term opioid remedy for ache with or with out opioid use dysfunction in British Columbia, Canada: a cohort retrospective examine” by Marie Claire Kennedy, Alexis Crabtree, and Syonide Nolan, Weng Yin Mok, Zishan Cui, Mei Chong, Amanda Sloenwhite and Lianping Te December 1, 2022, PLOS medication.
This examine was funded by a Canadian Institutes of Well being Analysis Venture grant. SN is supported by the Michael Smith Basis for Well being Analysis and Stephen Diamond Professor on the College of British Columbia in innovation in dependancy care. LT is supported by the Michael Smith Basis for Well being Analysis Scholar Award. Funders had no position in examine design, information assortment, evaluation, publication resolution, or manuscript preparation.