Patients on Higher Doses of Prescription Painkillers More Apt to Overdose

TUESDAY April 5, 2011 -- Patients who are prescribed higher doses of opioid painkiller drugs (such as Oxycontin or Vicodin) are at increased risk of death from overdose than those given lower doses, a new study finds.

In fact, the study, published in the April 6 issue of the Journal of the American Medical Association, found no increased risk for patients who take opioid painkillers both as-needed and as regularly scheduled doses.

"Between 1999 and 2007, the rate of unintentional overdose death in the United States increased by 124 percent, largely because of increases in prescription opioid overdoses," wrote Amy S.B. Bohnert of the Department of Veterans Affairs, Ann Arbor, Mich., and colleagues in a journal news release.

"Achieving a better understanding of the factors contributing to prescription opioid overdose death is an essential step toward addressing this troubling and dramatic increase in overdose mortality," they added.

For this study the researchers examined VA data on 750 accidental opioid overdose deaths that occurred from 2004 to 2008 and a random sample of almost 155,000 patients who received opioids to treat pain in 2004 or 2005.

The overdose rate among patients treated with opioids was 0.04 percent. Patients who died of an opioid overdose were much more likely to be middle-aged and white; more likely to have chronic or acute pain, more likely to have substance use disorders or other psychiatric diagnoses; and less likely to have cancer.

Patients who received a higher maximum daily dose (100 milligrams/day or more) were more likely to overdose than those who received a lower maximum daily dose (between 1 and 20 mg/day).

"The present findings highlight the importance of implementing strategies for reducing opioid overdose among patients being treated for pain," the researchers wrote.

"This study documents a relationship between opioid prescribing and opioid overdose in a large, national, prospective cohort of individuals receiving opioid therapy for a variety of medical conditions," they continued. "The risk of opioid overdose should continue to be evaluated relative to the need to reduce pain and suffering and be considered along with other risk factors."

More information

The U.S. Food and Drug Administration has more about opioids and other pain medicines.

Posted: April 2011


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