Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain

Wilder, Christine M.; Miller, Shannon C.; Tiffany, Elizabeth; Winhusen, Theresa; Winstanley, Erin L.; Stein, Michael D.

doi:10.1080/10550887.2016.1107264

Cited by 60 publications

(35 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CDC also highlighted not only the increase in overdose deaths from opioids, but also a major surge in www.painphysicianjournal.com illicit opioid overdose deaths, driven largely by heroin. These 2 trends, while distinct and separate, are also interrelated (2,4,52,126,149,(155)(156)(157)(158)(159)(338)(339)(340)(341)(342)(343)(344)(345)(346)(347). Ironically, the present interpretation of overdose deaths and their available data seem to lag behind the current status.…”

Section: S33mentioning

confidence: 99%

“…Thus, opioid abuse has become an international problem (1-4, 6,8,17,[19][20][21][22]29,30,[36][37][38]41,61,62,85,87,88,127,291,[338][339][340][341][342][343][344][345][346][347][348][349][350][351][352][353][354][366][367][368][369][370][371][372][373][374][375][376][377][378][379][380]. The impact of opioid abuse is widespread with escalating economic burden of prescription opioid use, misuse, abuse, and adverse conseque...…”

Section: S33mentioning

confidence: 99%

See 1 more Smart Citation

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Kaye²,

et al. 2017

View full text Add to dashboard Cite

Background: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl. Contrary to scientific evidence of efficacy and negative recommendations, a significant proportion of physicians and patients (92%) believe that opioids reduce pain and a smaller proportion (57%) report better quality of life. In preparation of the current guidelines, we have focused on the means to reduce the abuse and diversion of opioids without jeopardizing access for those patients suffering from non-cancer pain who have an appropriate medical indication for opioid use. Objectives: To provide guidance for the prescription of opioids for the management of chronic non-cancer pain, to develop a consistent philosophy among the many diverse groups with an interest in opioid use as to how appropriately prescribe opioids, to improve the treatment of chronic non-cancer pain and to reduce the likelihood of drug abuse and diversion. These guidelines are intended to provide a systematic and standardized approach to this complex and difficult arena of practice, while recognizing that every clinical situation is unique. Methods: The methodology utilized included the development of objectives and key questions. The methodology also utilized trustworthy standards, appropriate disclosures of conflicts of interest, as well as a panel of experts from various specialties and groups. The literature pertaining to opioid use, abuse, effectiveness, and adverse consequences was reviewed, with a best evidence synthesis of the available literature, and utilized grading for recommendation as described by the Agency for Healthcare Research and Quality (AHRQ).

show abstract

Section: S33mentioning

confidence: 99%

Section: S33mentioning

confidence: 99%

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Kaye²,

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Health care systems should be cognizant of how cost may affect patient acceptance of OEND, particularly considering that patients tend to underestimate their risk for overdose and potential need for naloxone. 11,12 To help facilities proactively identify patients who may be at increased risk for opioid overdose, national academic detailing and mental health program offices automated predictive analytic-based risk estimation tools that use electronic medical record data to identify at-risk patients (described in greater detail in Implementation and Evaluation Resources). These patient identification tools can be used to prompt shared-decision-making discussions between patients and providers regarding consideration of OEND.…”

Section: Stepmentioning

confidence: 99%

Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration’s national program

Oliva¹,

Christopher²,

Wells³

et al. 2017

Journal of the American Pharmacists Association

View full text Add to dashboard Cite

show abstract

“…Persons with opioid use disorders tend to underestimate their risk of opioid-related overdose (Frank et al, 2015; Wilder et al, 2016), and those opioid users who also use BZDs further underestimate their risk for overdose (i.e., present optimistic bias) (Rowe, Santos, Behar, & Coffin, 2016). Perceptions of risk are a key driver of behavior and thus represent an important target for prevention strategies (for review see Clark, Wilder, & Winstanley, 2014).…”

Section: 0 Introductionmentioning

confidence: 99%

Beliefs about the consequences of using benzodiazepines among persons with opioid use disorder

Stein

Anderson

Kenney

et al. 2017

Journal of Substance Abuse Treatment

Self Cite

View full text Add to dashboard Cite

Background Patients admitted to addiction treatment programs report high rates of concurrent opioid and benzodiazepine (BZD) use. This combination places individuals at high risk for accidental overdose and other serious consequences. However, little is known about the beliefs opioid users have about the consequences of BZD use. Methods We surveyed consecutive persons initiating inpatient opioid detoxification (N=476; 95.0% enrollment) and identified 245 who reported BZD use in the past 30 days and/or had a positive toxicology. We compared those who did and did not report BZD use on demographic and substance use variables, and specific beliefs about the potential effects of BZDs. Results Participants averaged 32.2 years of age, 71.2% were male, 86.6% used heroin, and 68.7% reported injection drug use in the past 30 days. Over half (51.5 %) used a BZD in the month prior to admission; of these, 26.2% (n = 64) reported being prescribed a BZD. Alprazolam (Xanax) was the most commonly used BZD (54%). Benzodiazepine users (versus non-users) were significantly more likely to be female and non-Hispanic White, use concurrent substances, and report past year overdose. Overall, nearly all BZD users endorsed accurate beliefs that BZDs can increase the risk of overdose and can be addictive. However, BZD users, relative to non-users, were significantly less likely to endorse some known adverse consequences of BZDs, such as risk of worsening depression and poor medication-assisted opioid treatment retention. Conclusions Delineating the full array of risks from combining BZDs and opioids should be a high priority in detoxification settings, given the increased risks associated with BZD misuse in this population.

show abstract

Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain

Cited by 60 publications

References 42 publications

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration’s national program

Beliefs about the consequences of using benzodiazepines among persons with opioid use disorder

Contact Info

Product

Resources

About