New Research Reveals Dangerous Consequences of Stopping Opioid Treatment for Chronic Pain

Opioid habit is a really serious public health issue that affects millions of men and women throughout the world. It is characterized by the compulsive use of opioids regardless of unfavorable implications, such as wellness problems, marriage problems, and money troubles. The dependancy can be brought about by a wide variety of factors, such as chronic ache, psychological health difficulties, and exposure to opioid medicine.

Discontinuation of opioid therapy for suffering may well increase the possibility of overdose in clients.

Opioid-connected overdose has turn out to be a key contributor to accidental deaths in the United States and Canada. A new analyze not too long ago printed in the journal PLOS Medicine, led by Mary Clare Kennedy of the University of British Columbia, Kelowna, Canada, indicates that halting recommended opioids may well boost the hazard of overdose.

In an effort and hard work to reduce opioid-relevant sickness and dying, Canada and the United States have recognized tips to limit opioid prescriptions for chronic pain. Even so, the influence of discontinuing opioid treatment plans on overdose chance continues to be largely unstudied. To investigate the relationship amongst discontinuing prescribed opioid remedy for agony and overdose risk, a group of researchers conducted a retrospective cohort research of men and women acquiring long-time period opioid treatment for ache in British Columbia in between Oct 2014 and June 2018. They analyzed the clinical information of 14,037 people registered with the provincial wellbeing insurance coverage shopper roster in British Columbia who had been on opioid therapy for at the very least 90 times.

The researchers found that discontinuing opioid remedy for discomfort was affiliated with improved overdose danger between people with no opioid use condition (OUD). However the affiliation was much better in these with OUD, including all those not acquiring opioid agonist treatment (AHR = 3.18 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 1.87 – 5.40, p<0.001) and receiving opioid agonist therapy (AHR = 2.52 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 1.68 – 3.78, p<0.001). Finally, tapering opioid therapy was associated with decreased risk of overdose in those with OUD who had not received opioid agonist therapy (AHR = 0.31, 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 0.14 – 0.67, p=0.003).

The study had several limitations as the outcome measure did not capture overdose events that did not involve a healthcare encounter or result in death. Additionally, the researchers were unable to determine the source of the drugs involved in overdoses and whether they were prescribed or obtained illicitly.

According to the authors, “These findings point to the need to avoid abrupt discontinuation of opioid treatment for pain and to enhance guidance for prescribers in modifying opioid treatment tapering strategies on the basis of opioid use disorder and opioid agonist therapy status.”

Kennedy adds, “Given the increased risk of overdose, sudden discontinuation of opioid treatment for chronic pain should be avoided in almost all instances. Enhanced guidance is needed to support prescribers in implementing safe and effective opioid for pain tapering strategies, with particular consideration of opioid use disorder and prescribed opioid agonist therapy status.”

Reference: “Discontinuation and tapering of prescribed opioids and risk of overdose among people on long-term opioid therapy for pain with and without opioid use disorder in British Columbia, Canada: A retrospective cohort study” by Mary Clare Kennedy, Alexis Crabtree, Seonaid Nolan, Wing Yin Mok, Zishan Cui, Mei Chong, Amanda Slaunwhite and Lianping Ti, 1 December 2022, PLOS Medicine.
DOI: 10.1371/journal.pmed.1004123

This study was funded by a Canadian Institutes of Health Research Project Grant. SN is supported by the Michael Smith Foundation for Health Research and the University of British Columbia’s Steven Diamond Professorship in Addiction Care Innovation. LT is supported by a Michael Smith Foundation for Health Research Scholar Award. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.