(Press-News.org) In an analysis of opioid prescription patterns and deaths, receiving higher prescribed doses is associated with an increased risk of opioid overdose death, but receiving both as-needed and regularly scheduled doses is not associated with overdose risk, according to a study in the April 6 issue of JAMA.
The rate of overdose death has increased sharply in the United States in the past decade and overdose death is a pressing public health problem, according to background information in the article. "Between 1999 and 2007, the rate of unintentional overdose death in the United States increased by 124 percent, largely because of increases in prescription opioid overdoses. Achieving a better understanding of the factors contributing to prescription opioid overdose death is an essential step toward addressing this troubling and dramatic increase in overdose mortality."
Amy S. B. Bohnert, Ph.D., of the Department of Veterans Affairs, Ann Arbor, Mich., and colleagues examined the relationship between opioid prescribing patterns (dose and schedule ["as needed," regularly scheduled, or both]) and risk of opioid-related deaths from 2004 through 2008 among diagnostic subgroups of patients (chronic pain, cancer, acute pain, and substance use disorders) in a national sample of Veterans Health Administration (VHA) patients. The study included data on all unintentional prescription opioid overdose decedents (n = 750) and a random sample of patients (n = 154,684) among those individuals who used medical services in 2004 or 2005 and received opioid therapy for pain.
The researchers approximated the rate of overdose among individuals treated with opioids to be 0.04 percent. Opioid overdose decedents were statistically significantly more likely to be middle-aged and white; more likely to have chronic or acute pain, substance use disorders, and other psychiatric diagnoses; and less likely to have cancer.
The authors found that the overdose rate was higher at higher maximum daily doses compared with lower maximum daily doses (100 mg/day or more vs. 1 mg/day to less than 20 mg/day) across all subgroups examined, including those with cancer, substance use disorders, chronic and acute pain.
Having as-needed opioids only compared with having regularly scheduled opioids was associated with an increase in risk of opioid overdose among patients with cancer. Receiving both as-needed and regularly scheduled doses was not associated with overdose risk after adjustment.
"The present findings highlight the importance of implementing strategies for reducing opioid overdose among patients being treated for pain," the authors write. "This study documents a relationship between opioid prescribing and opioid overdose in a large, national, prospective cohort of individuals receiving opioid therapy for a variety of medical conditions. The risk of opioid overdose should continue to be evaluated relative to the need to reduce pain and suffering and be considered along with other risk factors."
###(JAMA. 2011;305[13]1315-1321. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
To contact Amy S. B. Bohnert, Ph.D., call Ian Demsky at 734-764-2220 or email idemsky@med.umich.edu.
For More Information: Contact the JAMA/Archives Media Relations Department at 312-464-JAMA or email: mediarelations@jama-archives.org.
Risk of death from opioid overdose related to higher prescription dose
2011-04-06
ELSE PRESS RELEASES FROM THIS DATE:
The Latest Virtual Summit Press Release To Give Women Business Owners Less Stress And More Success.
2011-04-06
Six expert business coaches and consultants are launching a "virtual summit" designed to fit the busy schedules of women business owners. The Make it Happen! Virtual Summit kicks off April 19 and focuses on presenting information that can be implemented quickly into action steps leading to high-impact results.
The Make it Happen Virtual Summit is geared to women who are ready to strategically prioritize their business and life goals to enhance professional success and personal fulfillment with less stress. Topics include developing a powerful profit-boosting marketing ...
HIV-1 drug resistance mutations associated with increased risk of antiretroviral treatment failure
2011-04-06
An analysis of data from 10 studies indicates that the presence of low frequency (also called "minority") human immunodeficiency virus type 1 (HIV-1) drug resistance mutations, particularly those involving nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance, are significantly associated with an increased risk of first-line antiretroviral treatment failure, according to an article in the April 6 issue of JAMA.
Using traditional tests, the prevalence of transmitted drug resistance mutations is estimated to be between 8 percent and 16 percent among HIV-1 infected ...
Death rates after hospitalization down for oldest heart failure patients
2011-04-06
Death rates after hospitalization for heart failure have dropped for veterans age 80 and older, but rehospitalizations remain frequent, according to a study in the American Heart Association journal Circulation: Heart Failure.
Results of the study highlight a need to better identify which patients among the oldest are more likely to be rehospitalized not just for heart failure, but for any reason, said Rashmee Shah, M.D., lead author of the study and postdoctoral fellow in the Department of Health Research and Policy at Stanford University School of Medicine in Palo Alto, ...
AIT Becomes the First Software Vendor in American Translators Association's Member-Provider Program
2011-04-06
Advanced International Translations (AIT), a leading supplier of translation management software for agencies and freelancers, became the first member-provider software company in the American Translators Association (ATA).
ATA's Member-Provider Program was established to provide support to members in their practice of translation and interpreting. Vendors in the program are selected after careful review of the company's products, services, reliability, and value. The selection process includes feedback and recommendations from ATA members about the vendor and its products.
Participation ...
Off-label marketing of medicines in the US is rife but difficult to control
2011-04-06
Despite Federal Drug Administration regulation of the approval and use of pharmaceutical products, "off-label" marketing of drugs (for purposes other than those for which the drug was approved) has occurred in all aspects of the US health care system. In a study published in this week's PLoS Medicine, Aaron S. Kesselheim from Brigham and Women's Hospital, Boston, USA and colleagues report that the most common alleged off-label marketing practices also appear to be the most difficult to control through external regulatory approaches. They identified three main goals of alleged ...
Comprehensive approach can improve clinical care of Kenyan children
2011-04-06
A multifaceted approach that addressed deficiencies in clinical knowledge, skills, motivation, resources, and the organization of care was associated with improvements in practice for high mortality conditions in young children in rural Kenya compared with less comprehensive approaches.
This finding from a novel study by Philip Ayieko from the KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, and colleagues, published in this week's PLoS Medicine, is important as it suggests that specific efforts are needed to improve pediatric care in rural areas of poor countries ...
Effects of pneumococcal vaccination program on pneumococcal carriage and invasive disease
2011-04-06
Using a cross-sectional study, Stefan Flasche and colleagues investigated the effects of the UK pneumococcal vaccination program on serotype-specific carriage and invasive pneumococcal disease.
There are more than 90 Streptococcus pneumoniae serotypes that can cause invasive pneumococcal disease (IPD). The pneumococcal conjugate vaccine PCV7 contains antigens from seven serotypes responsible for IPD. Immunization with PCV7 prevents both IPD disease and carriage of these seven serotypes, but after vaccination non-vaccine serotypes could colonize the nasopharynx. There ...
Ben Cohen: The Problem Solver for Company Energy Bill Expenditures
2011-04-06
For companies facing the ongoing challenge of energy related costs a New York based entrepreneur is offering instant lower pricing options via his Energy Deregulation Business Model. "The breakup of Ma Bell offered consumers the opportunity to shop for lower phone rates and that same situation is now available for energy consumers currently in the states of Texas, Connecticut, New Jersey, New York as well as parts of Pennsylvania and Illinois," said Ben Cohen.
Cohen's business solution (www.cohenenergysolutions.emexpower.com) allows clients to lock in on fixed rates ...
Sandia researchers merge gaming, simulation tools to create models for border security
2011-04-06
VIDEO:
Developed via funding from the Department of Homeland Security's Customs and Border Protection (CBP), the Borders High Level Model is a high-fidelity simulation and analysis program that aids policy and...
Click here for more information.
LIVERMORE, Calif. —With funding from the Department of Homeland Security's Customs and Border Protection (CBP), researchers at Sandia National Laboratories have developed a high-fidelity simulation and analysis program that aids ...
Einstein HR Announces New Offices To Meet High Demand For Outsourced HR Solutions
2011-04-06
Company founder and CEO Layne Davlin today announced that EinsteinHR has inaugurated new offices which will allow the company to better serve its expanded client-base. A dramatic increase in demand for outsourced HR solutions necessitated the move.
"EinsteinHR is strategically positioned for growing with existing accounts and acquiring new customers with a limited ramp-up time," says Layne Davlin.
Top-tier small- and medium-sized businesses rely on EinsteinHR in outsourcing everything from payroll and paying employment related taxes, to risk management, providing ...