Discontinuing opioid remedy for ache could improve the danger of overdose in sufferers.
Opioid-related overdoses have grow to be a significant contributor to unintended deaths in the USA and Canada. A brand new examine lately revealed within the journal PLOS medicationLed by Marie Claire Kennedy College of British Columbiakelowna, canada signifies that stopping prescribed opioids could improve the danger of overdose.
In an effort to scale back opioid-related deaths and sicknesses, Canada and the USA have established pointers to scale back opioid prescriptions for power 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 workforce 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 have been enrolled within the British Columbia Provincial Well being Insurance coverage consumer checklist who had been receiving opioid remedy for at the least 90 days.
Researchers discovered that discontinuing opioid remedy for ache was related to an elevated danger of overdose amongst folks 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 have been unable to find out the supply of the medication implicated within the overdose and whether or not they have 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 reinforce steering for prescribers in adjusting opioid remedy methods based mostly on opioid use dysfunction and opioid remedy standing.”
Kennedy provides: “Due to the elevated danger of overdose, abrupt discontinuation of opioid remedy for power ache must be prevented in virtually all circumstances. Improved steering is required to assist prescribers in implementing protected 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 danger 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 habit care. LT is supported by the Michael Smith Basis for Well being Analysis Scholar Award. Funders had no function in examine design, knowledge assortment, evaluation, publication choice, or manuscript preparation.