Discontinuing opioid remedy for ache might improve the danger of overdose in sufferers.
Opioid-related overdoses have grow to be a significant contributor to unintended deaths in america and Canada. A brand new research just lately printed within the journal PLOS medicationLed by Marie Claire Kennedy College of British Columbiakelowna, canada signifies that stopping prescribed opioids might improve the danger of overdose.
In an effort to scale back opioid-related deaths and diseases, Canada and america have established pointers to scale back opioid prescriptions for continual ache. Nevertheless, the impact of discontinuing opioid therapies on overdose danger stays largely unstudied. To analyze the connection between discontinuing prescribed opioid remedy for ache and danger of overdose, a crew of researchers performed 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 data for ache. 14,037 sufferers have been enrolled within the British Columbia Provincial Well being Insurance coverage consumer listing who had been receiving opioid remedy for no 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). Nevertheless, 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 research had a number of limitations as a result of the result measure didn’t seize overdose occasions that didn’t contain a healthcare encounter or result in dying. Moreover, the researchers have been unable to find out the supply of the medicine implicated within the overdose and whether or not they have been prescribed or obtained illegally.
In accordance with the authors, “These findings recommend the necessity to keep away from abrupt discontinuation of opioid remedy for ache and to boost steerage for prescribers in adjusting opioid remedy methods primarily based on opioid use dysfunction and opioid remedy standing.”
Kennedy provides: “Due to the elevated danger of overdose, abrupt discontinuation of opioid remedy for continual ache must be averted in nearly all circumstances. Improved steerage is required to help prescribers in implementing secure 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 Venture grant. SN helps 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 position in research design, information assortment, evaluation, publication resolution, or manuscript preparation.