Wednesday, February 17, 2016

Risk Factors for Opioid Overdose & Awareness of Overdose Risk among Veterans Prescribed Chronic Opioids for Addiction or Pain

Rising overdose fatalities among US veterans suggest veterans taking prescription opioids may be at risk for overdose. However, it is unclear whether veterans prescribed chronic opioids are aware of this risk.

The objective of this study was to identify risk factors and determine awareness of risk for opioid overdose in veterans treated with opioids for chronic pain, using veterans treated with methadone or buprenorphine for opioid use disorder as a high-risk comparator group.

Ninety veterans on chronic opioid medication for either opioid use disorder or pain management completed a questionnaire assessing risk factors, knowledge, and self-estimate of risk for overdose.

Nearly all veterans in both groups had multiple overdose risk factors although individuals in the pain management group had on average a significantly lower total number of risk factors than did individuals in the opioid use disorder group (5.9 v. 8.5, p<0.0001). On average, participants treated for pain management scored slightly but significantly lower on knowledge of opioid overdose risk factors (12.1 v. 13.5, p<0.01). About 70% of participants, regardless of group, believed their overdose risk was below that of the average American adult. There was no significant relationship between self-estimate of overdose risk and either number or knowledge of opioid overdose risk factors.

Our results suggest that veterans in both groups underestimated their risk for opioid overdose. Expansion of overdose education to include individuals on chronic opioids for pain management and a shift in educational approaches to overdose prevention may be indicated.

Below:  Participant estimate of risk for overdose on opioids in the next year, using visual analog scale graded from 0–100%

Full article at:

By:  Christine M. Wilder, M.D.,1,2,* Shannon C. Miller, M.D.,1,2 Elizabeth Tiffany, M.D.,2 Theresa Winhusen, Ph.D.,2 Erin L. Winstanley, Ph.D.,3 and Michael D. Stein, M.D.4
1Department of Veterans Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220
2Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229
3James L. Winkle College of Pharmacy, University of Cincinnati, PO Box 670004, Cincinnati, OH 45267-0004
4Department of Medicine, Alpert School of Medicine of Brown University, Butler Hospital, 345 Blackstone Blvd, Providence, RI 09206
*Corresponding Author: Christine M. Wilder, MD;

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