Nav: Home

Risky opioid prescriptions linked to higher chance of death

June 18, 2018

When patients are prescribed opioids in risky ways, their chance of dying increases and their odds of death go higher as the number of risky opioid prescriptions increase, according to a new RAND Corporation study.

Studying prescription records for residents of Massachusetts over a five-year period, researchers identified six types of risky opioid prescriptions and found that all were linked to a higher chance of death, including fatal opioid overdoses. The study found more than 6 percent of Massachusetts adults received a risky opioid prescription during the study period.

"Most people who misuse opioids are first exposed to the drugs through prescriptions so improving prescribing may be one way to reduce the risk of opioid misuse," said Dr. Adam J. Rose, the study's lead and a physician scientist at RAND, a nonprofit research organization. "Our study suggests that state prescription monitoring programs may help identify inappropriate prescribing in real time."

The study is the first to examine such a broad array of subtypes of risky prescribing of opioids and link such prescribing to a wide array of fatal outcomes. The findings are published online by the Journal of General Internal Medicine.

Opioid use disorders affect an estimated 9 out of every 1,000 Americans and opioid overdose-related deaths have quadrupled over the past 15 years. Public health campaigns are underway to educate prescribers and patients about the danger of high-dose opioids, and the importance of keeping first prescriptions low in dose and limited in duration.

The RAND study makes use of a unique database maintained by Massachusetts that tracks prescriptions and can be linked at the patient level to other information such as mortality, demographics and ambulance records. The database includes information about more than 98 percent of the state's residents.

The study looked for evidence for six different types of risky prescribing of opioids: high-dose opioid prescriptions; prescribing of opioids along with the anti-anxiety medication benzodiazepines; opioids prescribed to an individual by four or more prescribers in a calendar year; filling opioid prescriptions at four or more pharmacies in a year; paying cash for an opioid prescription three or more times over a three-month period; prescribing opioids without documentation of a pain diagnosis.

Researchers linked these six types of risky prescribing with nonfatal opioid overdoses, fatal opioid overdoses and all other causes of mortality.

The study found that more than half of Massachusetts adults received at least one opioid prescription between 2011 and 2015. More than 11 percent of of those patients experienced at least one kind of risky opioid prescription.

Receiving a risky prescription was more common with increasing age, with more than 13 percent of patients age 80 and older receiving at least one. Researchers say the finding is at odds with the public image of the opioid crisis as a problem of young people, but researchers say older adults simply may receive more medications.

The strongest association for any cause of death was receiving a high-dose prescription for opioids and lacking a documented pain diagnosis. Five of the six kinds of risky prescriptions were associated with a fatal opioid overdose. The exception was making cash payments for opioids.

"Our findings underscore the importance of potentially inappropriate prescribing of opioids as a contributing factor for fatal opioid overdoses and may help guide efforts to address the problem," Rose said. "This could provide the basis for a system that could flag providers in real time when they are writing a potentially inappropriate prescription for opioids."
-end-
Support for the study was provided by the General Electric Foundation. Other authors of the study are Dana Bernson and Thomas Land of the Massachusetts Department of Public Health, Kenneth Kwan Ho Chui and Thomas J. Stopka of Tufts University School of Medicine, Dr. Alexander Y. Walley and Dr. Marc R. LaRochelle of the Boston University School of Medicine, and Dr. Bradley D. Stein of RAND and the University of Pittsburgh School of Medicine.

RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.

RAND Corporation

Related Opioids Articles:

Opioids for chronic non-cancer pain doubled in quarter century
A review of 24 years of global research has shown opioid prescribing doubled between 1991-2015, with demand most common for chronic conditions such as chronic lower back pain, finds University of Sydney-led research.
Cancer screening among women prescribed opioids
US women who take prescription opioids are no less likely to receive key cancer screenings when compared to women who are not prescribed opioids.
Parents: Turkey makes great leftovers -- opioids do not
Leftover prescription opioids pose big risks to kids, yet most parents keep their own and their child's unused painkillers even after they're no longer medically necessary for pain.
Co-addiction of meth and opioids hinders treatment
A study published in the Journal of Substance Abuse Treatment found that methamphetamine use was associated with more than twice the risk for dropping out of treatment for opioid-use disorder.
Computer game may help to predict reuse of opioids
A computer betting game can help predict the likelihood that someone recovering from opioid addiction will reuse the pain-relieving drugs, a new study shows.
Postpartum women are getting prescribed more opioids than needed
New University of Minnesota Medical School research finds postpartum women are generally getting prescribed more narcotics than they need.
Cannabis found not to be a substitute for opioids
The research team looked at all research on the effects of cannabis use on illicit opioid use during methadone maintenance therapy, which is a common treatment for opioid use disorder, and found six studies involving more than 3,600 participants.
VA investigates impact of opioids, sedatives on veterans
Nearly 20 veterans kill themselves each day in the United States, a statistic that has led the Department of Veterans Affairs to make suicide prevention its highest priority and to recognize the risks from the simultaneous use of opioids and benzodiazepines.
Of all professions, construction workers most likely to use opioids and cocaine
Construction workers are more likely to use drugs than workers in other professions, finds a study by the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.
US-born residents more than 5 times likely to use prescription opioids than new immigrants
The longer immigrants live in the United States, the more likely they are to use prescription opioids -- a fact that contradicts popular views linking wealth and health, and suggests that American culture is uniquely favorable toward prescribing opioids.
More Opioids News and Opioids Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Making Amends
What makes a true apology? What does it mean to make amends for past mistakes? This hour, TED speakers explore how repairing the wrongs of the past is the first step toward healing for the future. Guests include historian and preservationist Brent Leggs, law professor Martha Minow, librarian Dawn Wacek, and playwright V (formerly Eve Ensler).
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.