2018
DOI: 10.1002/pds.4572
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Opioid tolerance and clinically recognized opioid poisoning among patients prescribed extended‐release long‐acting opioids

Abstract: Over one-third of patients initiating ≥90 MME ER/LA opioids did not have evidence of opioid tolerance. The 7 days following high dose ER/LA initiation may represent a high-risk period for clinically diagnosed opioid poisoning in patients who do not have prior opioid tolerance.

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Cited by 26 publications
(37 citation statements)
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“…Between 2011 and 2013, the initiation of opioid therapy in more than 182 000 long‐stay nursing home residents was largely aligned with the CDC prescribing guidelines, with only 2% of patients receiving long‐acting opioids at the start of therapy . Young et al studied the recommendation to prescribe the lowest effective dosage when initiating opioid therapy, while avoiding an increase in dosages of extended release and long‐acting (ER/LA) opioids to 90 morphine milligram equivalents (MME) or more per day, in combination with the label recommendation to establish opioid tolerance before initiation of higher dose ER/LA opioids . A large database covering over 147 million inhabitants in the United States with employer‐based insurance was used to identify adult patients initiating ER/LA opioids greater than or equal to 90MME.…”
Section: Compliance With Clinical Guidelinesmentioning
confidence: 94%
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“…Between 2011 and 2013, the initiation of opioid therapy in more than 182 000 long‐stay nursing home residents was largely aligned with the CDC prescribing guidelines, with only 2% of patients receiving long‐acting opioids at the start of therapy . Young et al studied the recommendation to prescribe the lowest effective dosage when initiating opioid therapy, while avoiding an increase in dosages of extended release and long‐acting (ER/LA) opioids to 90 morphine milligram equivalents (MME) or more per day, in combination with the label recommendation to establish opioid tolerance before initiation of higher dose ER/LA opioids . A large database covering over 147 million inhabitants in the United States with employer‐based insurance was used to identify adult patients initiating ER/LA opioids greater than or equal to 90MME.…”
Section: Compliance With Clinical Guidelinesmentioning
confidence: 94%
“…Aside from the level of evidence, it is useful to know to what extent these guidelines are followed in practice. In the current issue of Pharmacoepidemiology and Drug Safety , two papers have assessed compliance with CDC recommendations . Hunnicutt et al have studied opioid prescribing in nursing homes in the United States in light of the recommendations to use immediate‐release opioids when starting treatment .…”
Section: Compliance With Clinical Guidelinesmentioning
confidence: 99%
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