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Opioid-related overdose is now a number one explanation for unintentional loss of life in america and Canada. A examine printed December 1st within the open entry journal PLOS Drugs by Mary Clare Kennedy at College of British Columbia, Kelowna, Canada, and colleagues suggests discontinuing prescribed opioids was related to elevated overdose threat.
Canada and america have applied pointers to limit opioid prescribing for persistent ache in an effort to scale back opioid-related sickness and loss of life. Nevertheless, the results of discontinuing opioid therapies on overdose threat are understudied. To be able to higher perceive associations between discontinuation of prescribed opioid remedy for ache and threat of overdose, researchers performed a retrospective cohort examine 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 least 90 days.
The researchers discovered that discontinuing opioid remedy for ache was related to elevated overdose threat amongst individuals 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 threat 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 examine had a number of limitations as the result measure didn’t seize overdose occasions that didn’t contain a healthcare encounter or lead to loss of life. Moreover, the researchers have been unable to find out the supply of the medication 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 threat of overdose, sudden discontinuation of opioid therapy for persistent ache needs to be averted in nearly all situations. Enhanced steering is required to assist prescribers in implementing secure and efficient opioid for ache tapering methods, with explicit consideration of opioid use dysfunction and prescribed opioid agonist remedy standing.”
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Supplies offered by PLOS. Notice: Content material could also be edited for fashion and size.
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