THURSDAY, Dec. 8, 2022 (HealthDay News) — Discontinuation of prescription opioids in people with chronic pain is associated with an increased risk of overdose, according to a study published online Dec. 1 in PLOS Medicine.
Mary Clare Kennedy, Ph.D., of the University of British Columbia-Okanagan in Kelowna, Canada, and colleagues used a 20 percent random sample of residents on the provincial health insurance client list to identify 14,037 people. 14 to 74 years of age on term opioid therapy for pain (≥90 days).
The investigators found that during a median of 3.7 years of follow-up, opioid discontinuation (an interval of at least seven days)[s] on therapy) was associated with an increased risk of overdose among people without opioid use disorder (OUD; adjusted hazard ratio [aHR], 1.44), people with OUD not receiving opioid agonist therapy (OAT; aHR, 3.18), and people with OUD receiving OAT (aHR, 2.52), after adjusting for a range of demographic exposures, prescription, comorbidity and sociostructural. Among people with OUD not receiving OAT, opioid tapering (two or more sequential reductions of ≥5 percent in mean daily morphine milligram equivalents) was associated with a decreased risk of overdose (aHR, 0.31).
“These findings point to the need to avoid abrupt discontinuation of opioid treatment for pain and to improve guidance for prescribers in modifying opioid tapering strategies based on OUD and OAT status,” they write. the authors.
