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closeHigh-Dose Opioid Therapy and the Risk of Opioid-Related Death
Posted by juurlink on 02 Sep 2015 at 18:46 GMT
As the senior author of this study, I wish to note the findings of an additional analysis conducted following publication.
As noted in the manuscript, we observed that patients prescribed high-dose opioids (200 milligrams of morphine or equivalent daily) for chronic pain were 24 times more likely to die of opioid-related causes than patients taking lower doses. We did not, however, explore the absolute risk of opioid-related death among these patients.
We have now performed this analysis. Among 319 men receiving high-dose opioid therapy, opioid-related death occurred in 12 (3.8%; 95% confidence interval 2.2 to 6.5%). Among 270 women receiving high-dose therapy, opioid-related death occurred in 6 (2.2%; 95% confidence interval 1.0% to 4.8%).
While the generalizability of these findings to other patients is uncertain, our finding that 3.8% of men and 2.2% of women prescribed high-dose opioids died of opioid-related causes is sobering. These observations should should give clinicians pause before prescribing of this sort is undertaken.
David Juurlink, MD, PhD
University of Toronto
Toronto, Canada