Author Interviews, Opiods, Pharmacology, University Texas / 11.12.2014
Opioids: Total and Daily Dose Both Indicators of Overdose Risk
MedicalResearch.com Interview with:
Barbara J Turner MD, MSEd, MA, MACP
James D and Ona I Dye Professor of Medicine
Director, Center for Research to Advance Community Health (ReACH)
University of Texas Health Science Center San Antonio
Medical Research: What is the background for this study? What are the main findings?
Dr. Turner: Daily dose of opioid analgesics has been widely used to assess the risk of overdose death and this risk has been reported to be greatest for a morphine equivalent dose at least 100 to 120 mg per day. However, the total dose of filled opioid prescriptions over a period of time may offer a complementary measure of the risk to that provided by the daily dose. In fact, the total dose is not necessarily a simple linear transformation of the daily dose because not all patients use opioids every day, instead it reflects the total amount of opioids available to a patient.
Among 206,869 national HMO patients aged 18-64 with non-cancer pain filling at least 2 schedule II or III opioid analgesic prescriptions, the rate of overdose was 471 per 100,000 person-years. Over the study period of 3.5 years, risk of drug overdose was two to three times greater for patients with a daily dose >100 mg regardless of the total dose filled or a daily dose of 50-99 mg with a high total dose (>1830 mg) filled a six month interval (versus no opioids). The overdose risk was increased slightly for 50-99 mg per day with a lower total dose and not increased at all for daily doses under 20 mg regardless of the total dose.
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