Patients may be at higher risk of overdose when opioid therapy for pain is discontinued

Opioid-related overdose is now a number one reason for unintended dying in the USA and Canada. A research printed December 1 within the open entry journal PLOS Medication by Mary Clare Kennedy at College of British Columbia, Kelowna, Canada, and colleagues suggests discontinuing prescribed opioids was related to elevated overdose danger.

Canada and the USA have applied pointers to limit opioid prescribing for persistent ache in an effort to scale back opioid-related sickness and dying. Nevertheless, the consequences of discontinuing opioid remedies on overdose danger are understudied.

In an effort to higher perceive associations between discontinuation of prescribed opioid remedy for ache and danger of overdose, researchers performed a retrospective cohort research of individuals receiving long-term opioid remedy for ache in British Columbia between October 2014 and June 2018. They analyzed the medical histories of 14,037 sufferers registered with the provincial medical health insurance shopper roster in British Columbia who had been on opioid remedy for a minimum of 90 days.

The researchers discovered that discontinuing opioid remedy for ache was related to elevated overdose danger amongst folks with out opioid use dysfunction (OUD). But the affiliation was stronger in these with OUD, together with these not receiving opioid agonist remedy (AHR = 3.18; 95% CI = 1.87–5.40, popioid remedy was related to decreased danger of overdose in these with OUD who had not acquired opioid agonist remedy (AHR = 0.31, 95% CI = 0.14–0.67, p=0.003).

The research had a number of limitations as the end result measure didn’t seize overdose occasions that didn’t contain a healthcare encounter or lead to dying. Moreover, the researchers had been unable to find out the supply of the medication concerned in overdoses and whether or not they had been prescribed or obtained illicitly.

In keeping with the authors, “These findings level to the necessity to keep away from abrupt discontinuation of opioid remedy for ache and to reinforce steerage for prescribers in modifying opioid remedy tapering methods on the premise of opioid use dysfunction and opioid agonist remedy standing.”

Kennedy provides, “Given the elevated danger of overdose, sudden discontinuation of opioid remedy for persistent ache needs to be prevented in nearly all cases. Enhanced steerage is required to assist prescribers in implementing secure and efficient opioid for ache tapering methods, with specific consideration of opioid use dysfunction and prescribed opioid agonist remedy standing.”