Almost all patients continue to get opioid prescriptions after overdose

December 28, 2015

More than 90 percent of patients with chronic pain continue to receive prescription opioids after an overdose and are at high risk for experiencing a repeated overdose, according to an article published in Annals of Internal Medicine.

Nonfatal opioid overdose is an opportunity to identify and treat substance use disorders, but treatment patterns after the overdose are unknown. Utilizing Optum, a large national commercial insurance claims database with data on 50 million individuals over a 12 year period, researchers identified nearly 3,000 patients who experienced a nonfatal overdose while taking opioids prescribed for chronic pain. The data showed 91 percent of those patients continued to be prescribed opioids after the overdose. In addition, 70 percent received prescriptions from the same provider who prescribed them opioids before their initial overdose. At two years follow up, patients who continued taking high dosages of opioids were twice as likely to have another overdose compared to those who discontinued opioid use after the overdose.

According to the authors, the findings highlight the challenges faced by physicians to balance the known risks with potential benefits of prescription opioids for patients with chronic pain. They say their research reinforces the importance of developing tools that will help better identify and treat patients at risk for opioid use disorders and/or overdose.
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Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0038
URL live when embargo lifts

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, please contact Ellen Slingsby at ellen.slingsby@bmc.org or 617-638-8489.

American College of Physicians

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