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Reducing Opioid Analgesic Deaths in America: What Health Providers Can Do
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Journal Article
Reducing Opioid Analgesic Deaths in America: What Health Providers Can Do
2015
Overview
Background: Available data have shown steady increases of drug overdose deaths between
1992 and 2011. We review evidenced-based recommendations provided by a few prominent
North American pain societies and suggest ways on how health providers might help reduce
opioid analgesic deaths by implementing these practices.
Objective: To identify health care providers’ roles in reducing opioid analgesic deaths.
Study Design: A comprehensive review of current literature.
Methods: The review included relevant literature identified through searches of MEDLINE,
Cochran reviews, and Google Scholar, PubMed and EMBASE from January 1998 to January
2014. The level of evidence was classified as I (good), II (fair), and III (limited) based on the
quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF).
Results: Several practices such as too high doses overall, giving too high doses to opioid
naive patients, too fast opioid titration, insufficient use and knowledge of urine drug testing,
not updating knowledge of drug metabolism/interactions, and inadequate patient monitoring
are associated with higher risks of opioid analgesic deaths. Suboptimal risk stratification of
patients, rotation practices, and use of opioids analgesics in chronic noncancer pain are also
associated factors.
Limitations: There were a paucity of good evidence studies which show recommendations
reduce death.
Conclusion: Providers should be aware of all associated factors with opiate analgesic deaths
and apply the available evidence in reducing opioid analgesic deaths.
Key words: Opioid analgesic deaths, methadone deaths, opioid mortality, opioid guidelines,
genetic testing for opioids, urine drug testing
Publisher
American Society of Interventional Pain Physician
Subject
/ Analgesics - therapeutic use
/ Analgesics, Opioid - adverse effects
/ Analgesics, Opioid - therapeutic use
/ Drug Overdose - prevention & control
/ Health Personnel - standards
/ Humans
/ Substance Abuse Detection - methods
/ Substance Abuse Detection - mortality
