Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Higher opioid dose linked to overdose risk in chronic pain patients

19.01.2010
Study is first to examine how overdose risk differs by prescribed dose

More and more Americans with chronic pain not caused by cancer are taking medically prescribed opioids like Oxycontin (oxycodone) and Vicodin (hydrocodone).

The January 19 Annals of Internal Medicine features the first study to explore the risk of overdose in patients prescribed opioids for chronic noncancer pain in general health care. The study links risk of fatal and nonfatal opioid overdose to prescription use—strongly associating the risk with the prescribed dose.

A team led by Michael Von Korff, ScD, a senior investigator at Group Health Research Institute, studied nearly 10,000 patients who received multiple opioid prescriptions for common chronic pain conditions like back pain and osteoarthritis. Patients who received higher opioid doses were 9 times more likely to overdose than were those receiving low doses. Still, most of the overdoses occurred among patients receiving low to medium doses, because prescriptions at those levels were much more common.

More than 8 million U.S. adults—3 percent of all of them—are estimated to be using opioids long-term for chronic pain. The Centers for Disease Control and Prevention (CDC) recently reported that nearly 14,000 U.S. deaths involved prescription opioids in 2006, more than triple the number in 1999. Between 1999 and 2006, nearly 65,000 drug overdose deaths in the United States were reported to involve opioid analgesics.

"Some studies have indicated that fatal opioid overdoses occur most often among people abusing prescription drugs or obtaining them from non-medical sources," Dr. Von Korff said. "But our results suggest that many overdoses may occur among people using prescribed opioids."

Dr. Von Korff said that this research and the data reviewed cannot determine whether higher doses are a cause of overdose, but he noted that physicians should carefully evaluate and closely monitor patients using opioids long-term.

Previous research had not tracked nonfatal overdoses. "Fatal overdose may be only the tip of the iceberg," said Dr. Von Korff. "For every fatal overdose in our study, 7 nonfatal overdoses occurred, and most of the nonfatal overdoses were medically serious."

"Our findings are concerning and need to be studied in larger populations," said the study's first author, Kate M. Dunn, PhD, senior lecturer in epidemiology at the Arthritis Research Campaign National Primary Care Centre at Keele University in the U.K.

Opioid overdose occurred at similar rates across all ages. The overdose events identified were not directly evaluated to assess all potential contributing factors, such as suicide attempts, opioids obtained from nonmedical sources, or accidental or intentional ingestion of more opioid than prescribed. Although suicide attempts and drug abuse were noted in only a minority of the overdoses in this study, opioid overdoses appeared to occur more often among patients with a history of depression or substance abuse, Dr. Dunn said. Depression tends to be common among chronic pain patients using opioids long-term.

"Nationwide, opioids are widely prescribed long-term for many patients with chronic non-cancer pain," said coauthor Bruce M. Psaty, MD, PhD, a senior investigator at Group Health Research Institute and a professor of medicine, epidemiology, and health services at the University of Washington, where he co-directs the Cardiovascular Health Research Unit. "So a significant opportunity exists to improve safety and the risk-benefit profile through more careful and cautious prescribing."

Opioids include not only opiates, which come from the opium poppy, he explained—but also similar synthesized chemicals.

A three-year grant from the National Institute on Drug Abuse, part of the National Institutes of Health, funded the CONSORT (CONsortium to Study Opioid Risks and Trends) study. The Wellcome Trust supported Dr. Dunn's participation.

Other coauthors were Senior Investigator Carolyn M. Rutter, PhD, and Analyst/Programmer Kathleen W. Saunders, JD, of Group Health Research Institute; Caleb J. Banta-Green, MSW, MPH, PhD, Joseph O. Merrill, MD, MPH, and Mark D. Sullivan, MD, PhD, of the University of Washington; Michael J. Silverberg, PhD, MPH, and Cynthia I. Campbell, PhD, of Northern California Kaiser Permanente in Oakland; and Constance M. Weisner, DrPH, MSW, of Northern California Kaiser Permanente in Oakland and the University of California, San Francisco.

Group Health Research Institute

Founded in 1947, Group Health Cooperative is a Seattle-based, consumer-governed, nonprofit health care system. Group Health Research Institute (www.grouphealthresearch.org) changed its name from Group Health Center for Health Studies on September 8, 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.

Rebecca Hughes | EurekAlert!
Further information:
http://www.ghc.org

More articles from Studies and Analyses:

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

nachricht Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

Molecular volume control

22.08.2017 | Life Sciences

When fish swim in the holodeck

22.08.2017 | Life Sciences

Biochemical 'fingerprints' reveal diabetes progression

22.08.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>