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- Title
2015 - Use of long-acting, vs short-acting, opioids for chronic pain was linked to unintentional overdose.
- Authors
Holbrook, Anne
- Abstract
Methods Design Retrospective cohort study with linkage of Veterans Health Administration (VHA) databases. Setting USA. Patients 840 606 veterans with CNCP (mean age 60 y, 94% men) who filled new prescriptions (≥ 6 mo with no opioid use before index prescription) for short- (n = 801 729) or long-acting (n = 18 887) opioids and had ≥ 1 inpatient or outpatient encounter with the VHA in the year before the index prescription. Exclusion criteria included enrolment in hospice in the year before the index prescription or ineligibility for VHA benefits. Risk factors Duration of opioid action and duration of opioid use. Outcomes Unintentional overdose (events coded as drug or medication poisonings of accidental or undetermined intent, without accompanying code for external cause of injury). Main result Compared with short-acting opioids, use of long-acting opioids was associated with increased risk for unintentional overdose overall, with the risk seeming to be highest in the first 14 days (Table). Conclusion In veterans with chronic noncancer pain, use of long-acting opioids was associated with unintentional overdose events compared with short-acting opioids, especially in the first 14 days of use.
- Subjects
UNITED States; CHRONIC pain; CONFIDENCE intervals; DATABASES; DRUG overdose; MEDICAL information storage &; retrieval systems; LONGITUDINAL method; VETERANS; MEDICAL prescriptions; NARCOTICS; RETROSPECTIVE studies; TREATMENT duration; DESCRIPTIVE statistics
- Publication
ACP Journal Club, 2015, Vol 163, Issue 2, p10
- ISSN
1056-8751
- Publication type
Article