Study suggests prescribing guidelines for people without opioid use disorder may be ineffective – ScienceDaily

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Opioid-related overdoses are now a leading cause of accidental death in the United States and Canada. Study published on December 1Street In Open Access Journal PLOS medicine By Marie-Claire Kennedy of the University of British Columbia, Kelowna, Canada, and colleagues suggest that stopping prescription opioids is associated with an increased risk of overdose.

Canada and the United States have implemented guidelines to restrict the prescribing of opioids for chronic pain in an effort to reduce opioid-related illness and death. However, the effects of discontinuing opioid treatments on overdose risk have not been well studied. In order to better understand the associations between discontinuing prescribed opioid treatment for pain and risk of overdose, researchers conducted a retrospective cohort study of people receiving long-term opioid treatment for pain in British Columbia between October 2014 and June 2018. They analyzed the medical histories of 14,037 patients enrolled in a list British Columbia provincial health insurance clients who have been receiving opioid treatment for at least 90 days.

Researchers found that discontinuing opioid treatment for pain was associated with an increased risk of overdose among people without opioid use disorder (OUD). However, the association was stronger in those with OUD, including those not receiving opioid agonist treatment (AHR = 3.18; 95% CI = 1.87–5.40, p < 0.001) and receiving opioid agonist treatment (AHR = 2.52; 95). %CI = 1.68 - 3.78, p < 0.001). Finally, reducing opioid treatment was associated with a reduced risk of overdose in those with OUD who did not receive opioid agonist treatment (AHR = 0.31, 95% CI = 0.14–0.67, p = 0.003).

The study had several limitations because the outcome measure did not capture overdose events that did not involve a healthcare encounter or lead to death. Additionally, the researchers were unable to determine the source of the drugs implicated in the overdose and whether they were prescribed or obtained illegally.

According to the authors, “These findings suggest the need to avoid abrupt discontinuation of opioid treatment for pain and to enhance guidance for prescribers in adjusting opioid treatment strategies based on opioid use disorder and opioid treatment status.”

Kennedy adds: “Because of the increased risk of overdose, abrupt discontinuation of opioid treatment for chronic pain should be avoided in nearly all settings. Strengthened guidance is needed to support prescribers in implementing safe and effective strategies to reduce pain, with particular consideration for the opioid use disorder and condition of the prescribed opioid agonist treatment.” “.

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