Should Chronic Pain Patients Continue to Receive Painkillers After Overdosing?

By John Lavitt 01/29/16

Patients labeled a "high risk" for repeating an overdose are being given drugs by their doctors.

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A new study has found that more than 90% of patients with chronic non-cancer pain continue to receive prescription opioids after an overdose.

Published in the Annals of Internal Medicine, the report on the study noted that these patients remain at a "high risk" for experiencing a repeated overdose. To compile data for the study, the researchers used Optum, a large national commercial insurance claims database with data on 50 million individuals collected over a 12-year period.

Long-term opioid therapy for chronic non-cancer pain has become increasingly common in community practice. As a direct result, the rates of fatal and nonfatal opioid overdoses have significantly increased in the 21st century. The objective of the study was to estimate rates of opioid overdose among patients receiving medically prescribed, long-term opioid therapy and their association with an ongoing prescribed daily opioid dose after such an overdose.

The researchers identified nearly 3,000 patients who experienced a non-fatal overdose while taking opioids prescribed for chronic pain. The surprising data showed 91% of those patients continued to be prescribed opioids after the overdose. Most of those patients failed to receive ongoing counseling or recorded prevention education by their medical providers after such an overdose. This lack of follow-up support is disturbing when you consider that 70% of those patients received prescriptions from the same medical provider.

At the two year follow-up, the study found that patients who continued taking high dosages of opioids were twice as likely to have another overdose compared to those who discontinued opioid use after the overdose. Such an outcome is not surprising. Increased overdose risk among patients receiving higher dose regimens may also be due to the misuse and abuse of opioids in ways not intended by prescribing physicians.

Overall, the study's findings highlight the challenges faced by physicians to balance the known risks of opioid use for patients with chronic non-cancer pain with potential benefits of such prescriptions. The research reinforces the importance of developing tools that will help better identify and treat patients at risk for opioid use disorders and overdose. Even more important, educating medical providers of how to properly treat chronic pain patients after such an overdose is an essential step to take.

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles with his beautiful wife, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.

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