Chronic Pain, Depression, Anxiety Are Factors In Many Opioid Deaths

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A new study reveals that people at greatest risk for opioid death are those with chronic pain, and psychiatric disorders.

Led by Columbia University Medical Center investigators, this study was the first to determine the percentage of opioid deaths associated with specific health conditions.

For their work, the researchers examined the clinical diagnosis and filled prescriptions of more than 13,000 adults who died from an opioid overdose. They found that during the final year of their life, more than 50 percent of these individuals were diagnosed with chronic pain, and many were also given a depression or anxiety diagnosis.

“The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems,” said Mark Olfson, M.D., professor of psychiatry at CUMC and lead study investigator. “Such a strategy might increase early clinical intervention in patients who are at high risk for fatal opioid overdose.”

About a third of the people who died had been given a drug use disorder diagnosis during the previous year, though in their final month fewer than one in twenty was diagnosed with an opioid use disorder. Since a clinical diagnosis typically signifies treatment, the data suggest that dropping out of drug treatment is a common occurrence prior to a fatal overdose.

“Improving treatment retention with contingency management or other effective behavioral interventions might help lower the risk of fatal overdose in these patients,” says Dr. Olfson.

More than half of those who overdosed filled prescriptions for opioids or benzodiazepines during their final year, and many filled prescriptions for both. Using this drug combination raises the risk for extremely slow and shallow breathing—the main cause of death in most opioid overdose fatalities. The research team urges healthcare providers to use this medication combination sparingly, and only when other therapies have failed.

Source: Science Daily

 
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