Opioid Exposures Reported to U.S. Poison Centers

Rege, Saumitra V.; Smith, Moira; Borek, Heather A.; Holstege, Christopher P.

doi:10.1080/10826084.2021.1914101

Cited by 4 publications

(8 citation statements)

References 67 publications

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“…One priority identified by the US Department of Health and Human Services is the need to strengthen epidemiological efforts through data-based public health surveillance. 6 Data sources include poison control centers, emergency departments, electronic health records, and crime laboratories 7 , 8 , 9 , 10 ; data from some of these sources have been correlated with drug overdose mortality. 10 , 11 , 12 , 13 , 14 For example, an increase in synthetic opioids identified in crime laboratory data was strongly correlated with drug overdose deaths in Ohio counties.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Urine Drug Test Results From Substance Use Disorder Treatment Practices and Overdose Mortality Rates, 2013-2020

et al. 2022

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Key Points Question Do urine drug test (UDT) results correlate with overdose mortality rates? Findings In this cross-sectional study of 500 000 unique urine specimens collected from substance use disorder treatment practices, UDT results for 5 drug categories were correlated with overdose mortality rates at national, state, and county levels. Correlation was strongest for synthetic opioids and methamphetamine, and multivariate regression analysis using state-level data revealed that synthetic opioid and methamphetamine UDT positivity rates were significantly associated with overdose deaths. Meaning This study’s findings suggest that UDT is a valuable data source that is capable of informing real-time surveillance efforts.

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Section: Introductionmentioning

confidence: 99%

Analysis of Urine Drug Test Results From Substance Use Disorder Treatment Practices and Overdose Mortality Rates, 2013-2020

et al. 2022

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“…3,4 In the 2011-2018 NPDS, those age 50+ comprised 23.4% of all opioid exposure cases but 29.6% of the opioid exposure cases with serious outcomes. 5 The study found that in all opioid exposure cases, exposures to 3+ medicines/substances increased the risk of a serious outcome by 250%. 5 Polypharmacy, most commonly defined as the co-use of multiple (eg, ≥5) medications, is widespread in older adults with multi-morbidity and complex drug regimens.…”

Section: Introductionmentioning

confidence: 95%

“…5 The study found that in all opioid exposure cases, exposures to 3+ medicines/substances increased the risk of a serious outcome by 250%. 5 Polypharmacy, most commonly defined as the co-use of multiple (eg, ≥5) medications, is widespread in older adults with multi-morbidity and complex drug regimens. 6,7 Polypharmacy has been associated with inappropriate prescribing/ use and adverse outcomes including frailty, falls, emergency department (ED) visits, hospitalization, and death.…”

Section: Introductionmentioning

confidence: 95%

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Choi

DiNitto

et al. 2022

Journal of Pharmacy Practice

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Objectives: To examine relationships between polypharmacy and level of healthcare service use among prescription opioid poisoning cases age 50 and older. Methods: Data came from the American Association of Poison Control Center’s National Poison Data System, 2015-2020. We used multinomial logistic regression to examine the study questions. Results: Of the 77 946 cases with prescription opioid exposures, 64.5% were managed at a healthcare facility (HCF). Of HCF-managed cases, 41.2% were treated/evaluated and released and 21.3% and 37.5% were admitted for noncritical care and critical care, respectively. Medications for cardiovascular disease, benzodiazepines, other types of sedatives/hypnotics, antipsychotics, muscle relaxants, acetaminophen, and gabapentin were associated with increased risk of admission to both noncritical and critical care compared to treatment/evaluation and release. Acetaminophen use had the highest relative risk ratios (RRRs) for noncritical care (1.70, 95% CI = 1.51-1.91) and critical care (1.56, 95% CI = 1.39-1.76). Each additional medication/substance used was associated with 1.14 (95% CI = 1.11-1.17) and 1.19 (95% CI = 1.16-1.22) greater risk of noncritical and critical care admissions, respectively. Conclusions: Among older-adult poison control center cases for prescription opioid exposures, co-use of several commonly prescribed/used medicines was associated with increased risk of admissions to both noncritical and critical care units. Careful monitoring of medication use among older adults who use prescription opioids may reduce the risk of unintentional and intentional opioid poisoning.

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“…A recent report examining the national patterns in opioid exposure reported to the US poison control centers indicated that the proportion of exposure with adverse drug events (ADEs) increased despite the overall decrease in the frequency and rate of opioid exposure from 2011 to 2018 (Rege et al, 2021). ADEs are reported in the US Food and Drug Administration Adverse Event Reporting System (FAERS), a large government database that consists of ADEs and medication error reports submitted through the MedWatch program primarily from healthcare professionals (Zhou and Hultgren, 2020).…”

Section: Introductionmentioning

confidence: 99%

Variation in adverse drug events of opioids in the United States

2023

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Background: The United States (US) ranks high, nationally, in opioid consumption. The ongoing increase in the misuse and mortality amid the opioid epidemic has been contributing to its rising cost. The worsening health and economic impact of opioid use disorder in the US warrants further attention. We, therefore, assessed commonly prescribed opioids to determine the opioids that were over-represented versus under-represented for adverse drug events (ADEs) to better understand their distribution patterns using the Food and Drug Administration’s Adverse Event Reporting System (FAERS) while correcting for distribution using the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS). Comparing the ratio of the percentage of adverse drug events as reported by the FAERS relative to the percentage of distribution as reported by the ARCOS database is a novel approach to evaluate post-marketing safety surveillance and may inform healthcare policies and providers to better regulate the use of these opioids.Methods: We analyzed the adverse events for 11 prescription opioids, when correcting for distribution, and their ratios for three periods, 2006–2010, 2011–2016, and 2017–2021, in the US. The opioids include buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, and tapentadol. Oral morphine milligram equivalents (MMEs) were calculated by conversions relative to morphine. The relative ADEs of the selected opioids, opioid distributions, and ADEs relative to distribution ratios were analyzed for the 11 opioids.Results: Oxycodone, fentanyl, and morphine accounted for over half of the total number of ADEs (n = 667,969), while meperidine accounted for less than 1%. Opioid distributions were relatively constant over time, with methadone repeatedly accounting for the largest proportions. Many ADE-to-opioid distribution ratios increased over time, with meperidine (60.6), oxymorphone (11.1), tapentadol (10.3), and hydromorphone (7.9) being the most over-represented for ADEs in the most recent period. Methadone was under-represented (<0.20) in all the three periods.Conclusion: The use of the FAERS with the ARCOS provides insights into dynamic changes in ADEs of the selected opioids in the US. There is further need to monitor and address the ADEs of these drugs.

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Opioid Exposures Reported to U.S. Poison Centers

Cited by 4 publications

References 67 publications

Analysis of Urine Drug Test Results From Substance Use Disorder Treatment Practices and Overdose Mortality Rates, 2013-2020

Analysis of Urine Drug Test Results From Substance Use Disorder Treatment Practices and Overdose Mortality Rates, 2013-2020

Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+

Variation in adverse drug events of opioids in the United States

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