Study: 90% overdosing on opioids continue with refills

Even after overdosing on opioid medications, more than nine out of 10 patients continued to get prescriptions for the powerful painkillers, according to a new study.  As a result, some went on to suffer another overdose.

The findings, published December 28 in Annals of Internal Medicine, are “highly concerning,” the study authors wrote.  The overdoses examined in the report were serious enough to send patients to emergency rooms or get them admitted to hospitals, so they should not have escaped their doctors’ attention.  But that may be exactly what happened, the researchers surmised.  In 70 percent of the cases, the physician who prescribed opioid painkillers after the overdose was the same as the one who wrote the prescription before the overdose.   That tends to support the idea that the prescribers simply weren’t aware that anything had gone awry.

“Prescribing guidelines clearly state that misuse of opioids and adverse effects are compelling reasons to discontinue opioids,” the study authors wrote.

Dr. Marc Larochelle, who studies addiction issues at the Boston University School of Medicine and his colleagues used a nationwide medical database to identify 2,848 people in the U. S. who had an opioid overdose that was bad enough to send them to the hospital but no serious enough to kill them.  All of these patients were on long-term opioid therapy to treat pain for diseases other than cancer.  Their prescription painkillers included morphine, codeine, oxycodone, hydrocodone and fentanyl.

The main thing the researchers wanted to know was whether these patients continued to get prescription painkillers after having a serious overdose.  The answer was clear: They did.  Overall, 91 percent of the patients got at least one opioid prescription after their nonfatal overdose.   A typical patient was tracked for 299 days, but some were tracked for well over a year.

The study was funded by the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services.