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 Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center

nachricht The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

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: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

Im Focus: Virtual Reality for Bacteria

An interdisciplinary group of researchers interfaced individual bacteria with a computer to build a hybrid bio-digital circuit - Study published in Nature Communications

Scientists at the Institute of Science and Technology Austria (IST Austria) have managed to control the behavior of individual bacteria by connecting them to a...

Im Focus: A space-time sensor for light-matter interactions

Physicists in the Laboratory for Attosecond Physics (run jointly by LMU Munich and the Max Planck Institute for Quantum Optics) have developed an attosecond electron microscope that allows them to visualize the dispersion of light in time and space, and observe the motions of electrons in atoms.

The most basic of all physical interactions in nature is that between light and matter. This interaction takes place in attosecond times (i.e. billionths of a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Midwife and signpost for photons

11.12.2017 | Physics and Astronomy

How do megacities impact coastal seas? Searching for evidence in Chinese marginal seas

11.12.2017 | Earth Sciences

PhoxTroT: Optical Interconnect Technologies Revolutionized Data Centers and HPC Systems

11.12.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>