Study IDs 10 risk factors for opioid overdose after prescription

Editor's Note

A large study led by researchers at McMaster University in Ontario, Canada, identified 10 predictors of opioid overdose after prescription for chronic pain, as published by CMAJ (Canadian Medical Association Journal) on October 23.

While there are screening tools to identify patients at higher risk of addiction or overdose, the researchers note that these have not been validated. Researchers instead sought to develop a set of specific patient and prescription characteristics that can identify these at-risk patients. 

They examined 28 studies that included almost 24 million patients in the US, Canada and the UK who had been prescribed opioids for chronic pain. The risk of fatal and nonfatal opioid overdose after prescription increased two- to six-fold with:

• high-dose opioids
• fentanyl prescription
• multiple opioid prescribers
• multiple dispensing pharmacies
• history of overdose
• current substance use disorder
• depression
• bipolar disorder
• other mental illness, or
• pancreatitis.

The researchers say they hope the evidence-based findings will help clinicians to understand risks before patients are prescribed opioids for chronic pain.