Tags

Type your tag names separated by a space and hit enter

Opioid Prescribing Patterns Before Fatal Opioid Overdose.
Am J Prev Med. 2020 02; 58(2):250-253.AJ

Abstract

INTRODUCTION

Although opioid prescribing has decreased since 2010, overdose deaths involving illicit opioids have continued to rise. This study explores prescribing patterns before fatal overdose of decedents who died of prescription and illicit opioid overdoses.

METHODS

This retrospective cohort study was conducted in 2019 and included all 1,893 Illinois residents who died of an opioid-related overdose in 2016. Each decedent was linked to any existing Prescription Monitoring Program records, calculating weekly morphine milligram equivalents for 52 weeks before overdose.

RESULTS

Among the 1,893 fatal opioid overdoses, 309 involved any prescription opioid and 1,461 involved illicit opioids without the involvement of prescription opioids. The death rate because of illicit opioids was 23/100,000 among black residents versus 10.5/100,000 among whites. During the last year of life, 76% of prescription opioid decedents filled any opioid prescription totaling 10.7 prescriptions per decedent, compared with 36% of illicit opioid decedents totaling 2.6 prescriptions per decedent. During the last week of life, 33% of prescription opioid decedents filled an opioid prescription totaling 0.42 prescriptions per decedent, compared with 4% of illicit opioid decedents totaling 0.05 prescriptions per decedent.

CONCLUSIONS

Prescribing patterns alone may not be sufficient to identify patients who are at high risk for opioid overdose, especially for those using illicit opioids. Interventions aimed at reducing opioid overdoses should take into account different patterns of opioid prescribing associated with illicit and prescription opioid overdose deaths and be designed around the local characteristics of the opioid overdose epidemic.

Authors+Show Affiliations

Pritzker School of Medicine, University of Chicago, Chicago, Illinois. Electronic address: aba28@uchicago.edu.Center for Addiction Research and Effective Solutions, American Institutes for Research, Washington, D.C.Prescription Monitoring Program, Illinois Department of Human Services, Springfield, Illinois.Office of the Director, Illinois Department of Public Health, Chicago, Illinois.Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

31959322

Citation

Abbasi, Ali B., et al. "Opioid Prescribing Patterns Before Fatal Opioid Overdose." American Journal of Preventive Medicine, vol. 58, no. 2, 2020, pp. 250-253.
Abbasi AB, Salisbury-Afshar E, Berberet CE, et al. Opioid Prescribing Patterns Before Fatal Opioid Overdose. Am J Prev Med. 2020;58(2):250-253.
Abbasi, A. B., Salisbury-Afshar, E., Berberet, C. E., Layden, J. E., & Pho, M. T. (2020). Opioid Prescribing Patterns Before Fatal Opioid Overdose. American Journal of Preventive Medicine, 58(2), 250-253. https://doi.org/10.1016/j.amepre.2019.09.022
Abbasi AB, et al. Opioid Prescribing Patterns Before Fatal Opioid Overdose. Am J Prev Med. 2020;58(2):250-253. PubMed PMID: 31959322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid Prescribing Patterns Before Fatal Opioid Overdose. AU - Abbasi,Ali B, AU - Salisbury-Afshar,Elizabeth, AU - Berberet,Craig E, AU - Layden,Jennifer E, AU - Pho,Mai T, PY - 2019/05/08/received PY - 2019/09/11/revised PY - 2019/09/12/accepted PY - 2020/1/22/entrez PY - 2020/1/22/pubmed PY - 2020/11/26/medline SP - 250 EP - 253 JF - American journal of preventive medicine JO - Am J Prev Med VL - 58 IS - 2 N2 - INTRODUCTION: Although opioid prescribing has decreased since 2010, overdose deaths involving illicit opioids have continued to rise. This study explores prescribing patterns before fatal overdose of decedents who died of prescription and illicit opioid overdoses. METHODS: This retrospective cohort study was conducted in 2019 and included all 1,893 Illinois residents who died of an opioid-related overdose in 2016. Each decedent was linked to any existing Prescription Monitoring Program records, calculating weekly morphine milligram equivalents for 52 weeks before overdose. RESULTS: Among the 1,893 fatal opioid overdoses, 309 involved any prescription opioid and 1,461 involved illicit opioids without the involvement of prescription opioids. The death rate because of illicit opioids was 23/100,000 among black residents versus 10.5/100,000 among whites. During the last year of life, 76% of prescription opioid decedents filled any opioid prescription totaling 10.7 prescriptions per decedent, compared with 36% of illicit opioid decedents totaling 2.6 prescriptions per decedent. During the last week of life, 33% of prescription opioid decedents filled an opioid prescription totaling 0.42 prescriptions per decedent, compared with 4% of illicit opioid decedents totaling 0.05 prescriptions per decedent. CONCLUSIONS: Prescribing patterns alone may not be sufficient to identify patients who are at high risk for opioid overdose, especially for those using illicit opioids. Interventions aimed at reducing opioid overdoses should take into account different patterns of opioid prescribing associated with illicit and prescription opioid overdose deaths and be designed around the local characteristics of the opioid overdose epidemic. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/31959322/Opioid_Prescribing_Patterns_Before_Fatal_Opioid_Overdose_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(19)30443-X DB - PRIME DP - Unbound Medicine ER -