Discontinuing opioid remedy for ache could improve the danger of overdose in sufferers.
Opioid-related overdoses have turn into a significant contributor to unintentional deaths in the USA and Canada. A brand new research not too long ago 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 cut back opioid-related deaths and sicknesses, Canada and the USA have established pointers to cut back opioid prescriptions for persistent 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 staff of researchers carried out a retrospective cohort research 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 had been enrolled within the British Columbia Provincial Well being Insurance coverage shopper listing who had been receiving opioid remedy for not less than 90 days.
Researchers discovered that discontinuing opioid remedy for ache was related to an elevated danger of overdose amongst individuals 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 diminished 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 research 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 had been unable to find out the supply of the medication implicated within the overdose and whether or not they had been prescribed or obtained illegally.
In keeping with the authors, “These findings counsel 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 persistent ache must be averted in virtually all instances. Improved steering is required to help 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 research” 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 research was funded by a Canadian Institutes of Well being Analysis Mission 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 research design, knowledge assortment, evaluation, publication determination, or manuscript preparation.