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

Qeadan, Fares and Madden, Erin Fanning (2021) Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions. Addiction, Early online, . (In Press) doi: 10.1111/add.15643.

External website: https://onlinelibrary.wiley.com/doi/10.1111/add.15...

AIMS: To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. A retrospective cohort study using data from the Health Facts® Database. Over 600 U.S. healthcare facilities took part.

PARTICIPANTS: Three patient groups were followed for 2 years during 2009-2017: 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). 58,083 bone fracture patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose , and number of subsequent overdoses. 19,529 CPS patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose and number of subsequent overdoses. 110,608 low back pain patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose and number of subsequent overdoses.

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.


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