Sufferers could also be at increased danger of overdose when opioid remedy for ache is discontinued

Opioid-related overdose is now a number one reason behind unintentional dying in america 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 america have carried out tips to limit opioid prescribing for continual ache in an effort to scale back opioid-related sickness and dying. Nevertheless, the results of discontinuing opioid therapies on overdose danger are understudied.

As a way to higher perceive associations between discontinuation of prescribed opioid remedy for ache and danger of overdose, researchers carried out 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 insurance shopper roster in British Columbia who had been on opioid remedy for at the very least 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, p<0.001) and receiving opioid agonist remedy (AHR = 2.52; 95% CI = 1.68–3.78, p<0.001). Lastly, tapering opioid remedy was related to decreased danger of overdose in these with OUD who had not obtained 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 end in dying. Moreover, the researchers have been unable to find out the supply of the medicine concerned in overdoses and whether or not they have been prescribed or obtained illicitly.

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

Kennedy provides, “Given the elevated danger of overdose, sudden discontinuation of opioid therapy for continual ache ought to be prevented in nearly all situations. Enhanced steering is required to help prescribers in implementing secure and efficient opioid for ache tapering methods, with explicit consideration of opioid use dysfunction and prescribed opioid agonist remedy standing.”