Nav: Home

New study reveals highest risk profiles for opioid overdose

April 13, 2017

Richmond, Va. - April 13, 2017 - Individuals suffering from a substance use disorder (SUD) or depression are among those at highest risk for a serious prescription opioid overdose, according to a study published in Pain Medicine.

The retrospective, case-control study analyzed and compared patients with an opioid prescription from two health care claims databases: the U.S. Veterans Health Administration (VHA) from 2010-12 (1.9 million patients) and a U.S. commercial health plan database (IMS PharMetrics Plus) from 2009-13 (18.3 million patients). Risk factors for overdose in the 7,234 overdose cases in the commercially insured population (CIP) were analyzed and compared with the risk factor profile for the 817 VHA overdose cases. This is the most comprehensive characterization and comparison published to date of U.S. medical users of prescription opioids and overdose cases.

The strongest risk factors for prescription opioid overdose in the CIP were diagnosed depression and SUD of any type -- not just opioid dependence, abuse or addiction. Other strongly associated factors included other mental health disorders; impaired liver, kidney, vascular or lung function; and non-cancer pancreatic disease. A high total daily opioid dose, certain opioids and extended-release or long-acting opioids also were strong predictors of overdose. Taking certain other medications that affect the mind or behavior, such as benzodiazepines or antidepressants, increased an opioid user's risk of overdose.

The risk factor profiles largely were similar between the two populations despite substantial population differences in demographics, pre-existing health conditions, current medications, recent emergency department visits and hospitalizations, as well as differences between the public and private health care systems including medication-prescribing practices and drug formularies.

There was considerably greater prescribing prevalence of higher total daily opioid doses, all opioids except morphine and methadone, and most non-opioid medications, including psychoactive drugs, in the CIP overall than in the VHA population. However, extended-release or long-acting opioids were prescribed only about half as frequently among overdose cases in the CIP as in VHA.

Prescription opioid sales have quadrupled in the United States between 1999 and 2010 [SEE FOOTNOTE 1], and opioid prescription use increased by 31 percent between 2000 and 2005 among commercially insured patients [SEE FOOTNOTE 2]. Between 2004 and 2012, opioid use increased 77 percent among VHA patients [SEE FOOTNOTE 3].

Pain management is complex and multidimensional, and the risk of an opioid overdose is dependent on multiple factors.

"Any treatment plan involving opioids requires an individualized approach due to the potential for a serious overdose in all patients, regardless of age or indication," said Barbara Zedler, M.D., senior author and chief medical officer of Venebio, a life sciences consultancy. "Safe and appropriate opioid prescribing requires a personalized approach that accounts for a patient's demographic and psychosocial characteristics, active clinical conditions, other medications and substances used, and opioid-specific characteristics."

Venebio is the developer of the only validated opioid risk index and clinical decision support tool available -- Venebio Opioid Advisor (VOA) -- that calculates a patient's likelihood of a life-threatening overdose from a prescription opioid, determines their personalized risk factor profile and gives individualized guidance regarding interventions that health care professionals can consider to reduce the patient's risk of overdose. Ongoing development of VOA is supported by a $1.5-million grant from the National Institute on Drug Abuse of the National Institutes of Health.
-end-
The study, "Risk Factors for Serious Prescription Opioid-induced Respiratory Depression or Overdose: Comparison of Commercially Insured and Veterans Health Affairs Populations" was co-funded by Venebio and Kaléo, Inc., a privately held pharmaceutical company. The full study can be read at: https://academic.oup.com/painmedicine/article/3611356/Risk-Factors-for-Serious-Prescription-Opioid and additional information is available at voa.venebio.com.

About Venebio

Venebio is a research consultancy that provides cost-effective, custom solutions for complex life sciences problems. By integrating the expertise of a global network of scientists in a broad range of biomedical fields, Venebio delivers comprehensive project management and start-to-finish problem solving in genetic and molecular epidemiology, pharmacoepidemiology and pharmacovigilance, personalized medicine, bioinformatics, systems biology, biomarker discovery, and epidemiologic literature reviews and analysis. Venebio's comprehensive services are offered to pharmaceutical companies, biotechnology and medical device companies, health care organizations, academic research centers, law firms, government entities and NGOs. Learn more at http://www.venebio.com.

Footnote 1: Paulozzi L, Jones C, Mack KA, Rudd R. Vital signs: Overdoses of prescription opioid pain relievers - United States, 1999-2008. MMWR Morb Mortal Wkly Rep 2011;60(43):1487-92.

Footnote 2: Sullivan MD, Edlund MJ, Fan MY, et al. Trends in use of opioids for non-cancer pain conditions 2000-2005 in commercial and Medicaid insurance plans: The TROUP study. Pain 2008; 138(2):440-9.

Footnote 3: Mosher HJ, Krebs EE, Carrel M, et al. Trends in prevalent and incident opioid receipt: An observational study in Veterans Health Administration 2004-2012. J Gen Intern Med 2015;30(5):597-604.

Venebio

Related Addiction Articles:

Using science to combat addiction
In this Policy Forum, Keith Humphreys and colleagues highlight the need for science, and particularly neuroscience, to inform policies that address addiction.
Could targeting oxtyocin help treat opioid addiction?
A new review of published research indicates that the oxytocin system -- a key player in social reward and stress regulation -- is profoundly affected by opioid use.
Potential new treatment for cocaine addiction
A team of researchers led by Cardiff University has discovered a promising new drug treatment for cocaine addiction.
New role for glial energy metabolism in addiction
Addiction may be viewed as a disorder of reward learning.
Hunting for the brain's opioid addiction switch
New research by Steven Laviolette's research team at Western University is contributing to a better understanding of the ways opiate-class drugs modify brain circuits to drive the addiction cycle.
Internet addiction and school burnout feed into each other
Excessive internet use contributes to the development of school burnout.
Videogame addiction linked to ADHD
Young and single men are at risk of being addicted to video games.
Study finds addiction associated with poor awareness of others
Developmental psychologist Maria Pagano, PhD, found adolescents with severe alcohol and other drug problems have a low regard for others, as indicated by higher rates of driving under the influence and having unprotected sex with a history of sexually transmitted disease.
Study reveals new mechanism in nicotine addiction
Two chemical signals, acetylcholine and glutamate, were known to act as part of the negative reward system that fuels craving, but it wasn't clear how this happened.
Prescription painkillers source of addiction for most women
Reseach shows that more than half of women and a third of men reported doctor-prescribed painkillers as their first contact with opioid drugs, a family of drugs which include prescription medicines such OxyContin and codeine, as well as illicit drugs such as heroin.

Related Addiction Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#SB2 2019 Science Birthday Minisode: Mary Golda Ross
Our second annual Science Birthday is here, and this year we celebrate the wonderful Mary Golda Ross, born 9 August 1908. She died in 2008 at age 99, but left a lasting mark on the science of rocketry and space exploration as an early woman in engineering, and one of the first Native Americans in engineering. Join Rachelle and Bethany for this very special birthday minisode celebrating Mary and her achievements. Thanks to our Patreons who make this show possible! Read more about Mary G. Ross: Interview with Mary Ross on Lash Publications International, by Laurel Sheppard Meet Mary Golda...