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Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose.
J Addict Med. 2019 Sep/Oct; 13(5):396-402.JA

Abstract

OBJECTIVES

Addiction and overdose related to prescription drugs continues to be a leading cause of morbidity and mortality in the United States. We aimed to characterize the prescribing of opioids and benzodiazepines to patients who had previously presented with an opioid or benzodiazepine overdose.

METHODS

This was a retrospective chart review of patients who were prescribed an opioid or benzodiazepine in a 1-month time-period in 2015 (May) and had a previous presentation for opioid or benzodiazepine overdose at a large healthcare system.

RESULTS

We identified 60,129 prescribing encounters for opioids and/or benzodiazepines, 543 of which involved a patient with a previous opioid or benzodiazepine overdose. There were 404 unique patients in this cohort, with 97 having more than 1 visit including a prescription opioid and/or benzodiazepine. A majority of prescriptions (54.1%) were to patients with an overdose within the 2 years of the documented prescribing encounter. Prescribing in the outpatient clinical setting represented half (49.9%) of encounters, whereas emergency department prescribing was responsible for nearly a third (31.5%).

CONCLUSIONS

In conclusion, prescribing of opioids and benzodiazepines occurs across multiple locations in a large health care system to patients with a previous overdose. Risk factors, such as previous overdose should be highlighted through clinical decision support tools in the medical record to help prescribers identify patients at higher risk and to mobilize resources for this patient population. Prescribers need further education on factors that place their patients at risk for opioid use disorder and on alternative therapies to opioids and benzodiazepines.

Authors+Show Affiliations

Atrium Health Musculoskeletal Institute, Department of Orthopaedic Surgery, Carolinas Trauma Network Research Center of Excellence, Atrium Health, Charlotte, NC (MKW, JRH, RBS, MJB, RF, EH, DL, SS); Poison Information Center, Atrium Health, Charlotte, NC (MB); Department of Emergency Medicine, Carolinas Trauma Network Research Center of Excellence, Atrium Health, Charlotte, NC (CG, MR, MG); Patient Safety, Atrium Health, Charlotte, NC, USA (SJ); Department of Internal Medicine, Atrium Health, Charlotte, NC (AS); US Acute Care Solutions, Atrium Health, Pineville, NC (BW); Adult Psychiatry, Atrium Health, Charlotte, NC (SW).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30844876

Citation

Griggs, Christopher, et al. "Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose." Journal of Addiction Medicine, vol. 13, no. 5, 2019, pp. 396-402.
Griggs C, Wyatt S, Wally MK, et al. Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose. J Addict Med. 2019;13(5):396-402.
Griggs, C., Wyatt, S., Wally, M. K., Runyon, M., Hsu, J. R., Seymour, R. B., Beuhler, M., Bosse, M. J., Fogg, R., Gibbs, M., Haas, E., Jarrett, S., Leas, D., Saha, A., Schiro, S., & Watling, B. (2019). Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose. Journal of Addiction Medicine, 13(5), 396-402. https://doi.org/10.1097/ADM.0000000000000513
Griggs C, et al. Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose. J Addict Med. 2019 Sep/Oct;13(5):396-402. PubMed PMID: 30844876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose. AU - Griggs,Christopher, AU - Wyatt,Stephen, AU - Wally,Meghan K, AU - Runyon,Michael, AU - Hsu,Joseph R, AU - Seymour,Rachel B, AU - Beuhler,Michael, AU - Bosse,Michael J, AU - Fogg,Ryan, AU - Gibbs,Michael, AU - Haas,Eric, AU - Jarrett,Steven, AU - Leas,Daniel, AU - Saha,Animita, AU - Schiro,Sharon, AU - Watling,Bradley, AU - ,, PY - 2019/3/8/pubmed PY - 2020/7/30/medline PY - 2019/3/8/entrez SP - 396 EP - 402 JF - Journal of addiction medicine JO - J Addict Med VL - 13 IS - 5 N2 - OBJECTIVES: Addiction and overdose related to prescription drugs continues to be a leading cause of morbidity and mortality in the United States. We aimed to characterize the prescribing of opioids and benzodiazepines to patients who had previously presented with an opioid or benzodiazepine overdose. METHODS: This was a retrospective chart review of patients who were prescribed an opioid or benzodiazepine in a 1-month time-period in 2015 (May) and had a previous presentation for opioid or benzodiazepine overdose at a large healthcare system. RESULTS: We identified 60,129 prescribing encounters for opioids and/or benzodiazepines, 543 of which involved a patient with a previous opioid or benzodiazepine overdose. There were 404 unique patients in this cohort, with 97 having more than 1 visit including a prescription opioid and/or benzodiazepine. A majority of prescriptions (54.1%) were to patients with an overdose within the 2 years of the documented prescribing encounter. Prescribing in the outpatient clinical setting represented half (49.9%) of encounters, whereas emergency department prescribing was responsible for nearly a third (31.5%). CONCLUSIONS: In conclusion, prescribing of opioids and benzodiazepines occurs across multiple locations in a large health care system to patients with a previous overdose. Risk factors, such as previous overdose should be highlighted through clinical decision support tools in the medical record to help prescribers identify patients at higher risk and to mobilize resources for this patient population. Prescribers need further education on factors that place their patients at risk for opioid use disorder and on alternative therapies to opioids and benzodiazepines. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/30844876/Prescribing_of_Opioids_and_Benzodiazepines_Among_Patients_With_History_of_Overdose_ L2 - https://doi.org/10.1097/ADM.0000000000000513 DB - PRIME DP - Unbound Medicine ER -