Deaths from narcotic overdose have jumped tremendously in the past years – to the point where naloxone distribution has become a life-saving public health initiative. But, far more effective than treatment of overdose is prevention – and this small retrospective evaluation of Medicaid enrollees provides an insight into those at risk.
Based on an analysis of 90,010 Medicaid beneficiaries prescribed long-term opiate therapy, these authors made the following observations:
- Patients without overlapping narcotic prescriptions, and who did not fill prescriptions at more than 3 pharmacies: 0.63% overdose incidence
- Patients with overlapping narcotic prescriptions, and who filled prescriptions at more than 3 pharmacies: 6.09% overdose incidence
Other strongly predictive features for overdose were:
- Morphine equivalent opioid doses >50mg per day
- Concurrent sedative use
- History of alcohol abuse
- Depression diagnosis
Considering the increasing morbidity and mortality associated with opioid use and abuse, studies such as these help proactively identify those at greatest risk for early intervention.
“Defining Risk of Prescription Opioid Overdose: Pharmacy Shopping and Overlapping Prescriptions Among Long-Term Opioid Users in Medicaid”
http://www.ncbi.nlm.nih.gov/pubmed/25681095