Measures of Opioid Misuse Predict Future Opioid Overdose and Death Save

The current issue of Annals of Internal Medicine examines patterns of potential opioid misuse that are associated with subsequent adverse outcomes nationally.

Researchers analyzed a 5% sample of Medicare beneficiaries who had an opioid prescription, without a cancer diagnosis.  Specifically the sought to correlate a diagnosis of opioid overdose with other measures of opioid misuse including:

• drug quantity,
• overlapping prescriptions,
• use of multiple prescribers or pharmacies, or
• use of out-of-state prescribers or pharmacies.

Misuse measures were seen in 0.6% to 8.5% of beneficiaries.

Subsequent opioid overdose was positively associated with successively greater numbers of prescribers or pharmacies or higher opioid quantities during the index period. Patients with increasing prescribers had a greater risk of opioid overdose.

These misuse measures should be a red flag for those at risk for opioid overdose and death.