Discontinuing opioid remedy for ache might improve the chance of overdose in sufferers.
Opioid-related overdoses have develop into a significant contributor to unintended deaths in the US and Canada. A brand new research lately revealed within the journal PLOS drugsLed by Marie Claire Kennedy College of British Columbiakelowna, canada signifies that stopping prescribed opioids might improve the chance of overdose.
In an effort to cut back opioid-related deaths and diseases, Canada and the US have established tips to cut back opioid prescriptions for continual ache. Nonetheless, the impact of discontinuing opioid therapies on overdose threat stays largely unstudied. To analyze the connection between discontinuing prescribed opioid remedy for ache and threat of overdose, a group 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 information for ache. 14,037 sufferers had been enrolled within the British Columbia Provincial Well being Insurance coverage shopper checklist 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 threat 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 diminished threat 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 loss of life. 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 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 threat of overdose, abrupt discontinuation of opioid remedy for continual ache must be averted in nearly 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 chance 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 drugs.
This research 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 dependancy 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.