Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions.

Aims: To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. Design A retrospective cohort study using data from the Health Facts Database. Setting: Over 600 United States healthcare facilities. Participants: Three patient groups were fol...

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Published in:Addiction Vol. 117; no. 2; pp. 457 - 472
Main Authors: Qeadan, Fares, Madden, Erin Fanning
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Feb2022
Online Access:View this record in EBSCOhost
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      dt: Feb2022
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions.
      aug:
        au:
          Qeadan, Fares
          Madden, Erin Fanning
        affil: Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way Ste A, Salt Lake City UT, 84108,, USA
      sug:
        subj:
          Naloxone
          Opiate Overdose
          Analgesics, Opioid
          Chronic Pain
          Prescribing Patterns
          Human
          Retrospective Design
          United States
          Shoulder Fractures
          Low Back Pain
          Confidence Intervals
          Harm Reduction
      ab: Aims: To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. Design A retrospective cohort study using data from the Health Facts Database. Setting: Over 600 United States healthcare facilities. Participants: Three patient groups were followed for 2 years during 2009 to 2017: individuals with shoulder or long bone fractures (n = 252 424), chronic pain syndrome (CPS) (n = 76 141), or non‐traumatic low back pain (n = 792 956) who received an opioid prescription. Groups were chosen based on previous work. Measurements The outcome was opioid overdose identified by International Classification of Diseases codes (ICDs) and the primary predictor was number of naloxone prescriptions identified by National Drug Codes (NDCs). Findings Opioid overdoses occurred among 0.16% of fracture patients (average follow‐up time to overdose [AFU] = 240 days), 1.28% of CPS patients (AFU = 244 days), and 0.30% low back pain patients (AFU = 264 days). A total of 58 083 bone fracture patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (hazard ratio [HR] = 1.87, 95% CI = 1.68–2.09), and number of subsequent overdoses (incidence rate ratio [IRR] = 1.89, 95% CI = 1.69–2.12). A total of 19 529 CPS patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.69, 95% CI = 1.61–1.78) and number of subsequent overdoses (IRR = 1.74, 95% CI = 1.67–1.83). A total of 110 608 low back pain patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.33, 95% CI = 1.27–1.40) and number of subsequent overdoses (IRR = 1.35, 95% CI = 1.29–1.41). Conclusions: Receiving a naloxone prescription appears to be associated with increased risk of subsequent opioid overdose among patients with acute and chronic pain, suggesting prescribers often identify patients most in need of naloxone.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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