Opioid-related overdoses have become a major cause of accidental deaths in the US and Canada, bringing a significant challenge to the healthcare sector.
In an effort to counter this crisis, guidelines have been implemented to limit opioid prescriptions for chronic pain.
However, the effects of discontinuing such treatments on the risk of overdosing are not well-studied.
The Study Overview
To address this gap, researchers from the University of British Columbia conducted a study to understand the relationships between the discontinuation of prescribed opioid therapy and the risk of overdose.
They carried out a retrospective cohort study involving people who were on long-term opioid therapy for pain in British Columbia from October 2014 to June 2018.
The Subjects and Findings
In total, the medical histories of 14,037 patients who had been on opioid therapy for at least 90 days were analyzed.
The findings showed that stopping opioid therapy was associated with an increased risk of overdose, especially among those with opioid use disorder (OUD).
This risk was higher in OUD patients, whether they were receiving opioid agonist therapy or not.
However, gradually reducing or “tapering” opioid therapy was associated with a decreased risk of overdose in those with OUD who had not received opioid agonist therapy.
The study had its limitations. For instance, it couldn’t account for overdose incidents that didn’t result in a healthcare encounter or death.
Additionally, it was impossible for the researchers to determine the source of the drugs involved in the overdoses, that is, whether they were prescribed opioids or obtained illegally.
Despite the limitations, the study highlights the risk associated with abrupt discontinuation of opioid treatment for chronic pain.
The authors stressed the need to enhance guidance for prescribers in adjusting opioid treatment strategies based on the patient’s OUD and opioid agonist therapy status.
They emphasized the importance of avoiding sudden discontinuation of opioid treatment for chronic pain in almost all cases.
They also called for improved guidance to support prescribers in implementing safe and effective strategies for tapering opioids for pain, especially considering patients’ OUD and prescribed opioid agonist therapy status.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
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The study was published in PLoS Medicine.
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