Researchers Call for Reform of Opioid Prescription Practices

Study finds overdose risk is greater in patients receiving higher versus lower doses
By Rick Ansorge
HealthDay Reporter

TUESDAY, Jan. 19 (HealthDay News) -- In patients receiving higher doses of prescribed opioids for chronic pain, overdoses are common, suggesting a need to reform prescribing practices, according to a study in the Jan. 19 issue of the Annals of Internal Medicine.

Kate M. Dunn, Ph.D., of Keele University in the United Kingdom, and colleagues studied 9,940 patients who received three or more opioid prescriptions within 90 days between 1997 and 2005 for chronic non-cancer pain. During the study period, they identified 51 opioid-related overdoses that resulted in six deaths.

Compared to patients received 1 to 20 milligrams per day of opioids, the researchers found that the overdose risk was 3.7 times higher in those receiving 50 to 99 milligrams per day, and 8.9 times higher in those receiving 100 or more milligrams per day. They also found that higher-dose opioid use was associated with annual overdose rates of 0.7 and 1.8 percent, respectively.

"The threat to patient safety is too great to allow current pain management and opioid-prescribing practices to remain as they are," state the authors of an accompanying editorial. "Dunn and colleagues' data show the need to assess the risk for opioid misuse, provide close oversight, dose judiciously, and continually reevaluate the benefit of these potentially risky drugs. Smarter, more responsible practices are the only hope to avoid tragic, avoidable deaths."

Several authors reported financial relationships with pharmaceutical companies such as Wyeth and Eli Lilly.

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