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Using Controlled Substance Receipt Patterns to Predict Prescription Overdose Death.

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Prescription drug monitoring programs (PMP) data reveal that higher opioid dosages (MME/day >100) significantly increase overdose death risk. PMP data can identify at-risk prescribing patterns linked to fatal overdoses.

Keywords:
Drug interactionsDrug overdoseOpioidsOverdose deathPrescription monitoring program

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Area of Science:

  • Public Health
  • Epidemiology
  • Pharmacology

Background:

  • Controlled substance prescribing trends are evaluated using state-level data from prescription drug monitoring programs (PMP).
  • The association between these prescribing trends and the risk of fatal prescription drug overdose is examined.

Purpose of the Study:

  • To analyze PMP data to understand the link between prescription patterns and overdose mortality.
  • To identify specific prescribing characteristics associated with increased risk of fatal drug overdose.

Main Methods:

  • Retrospective analysis of Maine PMP records for individuals who died from prescription overdose (2006-2010).
  • Matched cohort study comparing overdose decedents (n=690) with PMP users (n=34,500) based on age, gender, and residence.
  • Evaluation of opioid dosage (MME/day) and timing of prescriptions relative to overdose death.

Main Results:

  • Prescription opioids were implicated in 480 of 690 overdose deaths.
  • A significant increase in overdose death risk was observed with daily milligram morphine equivalent (MME) dosages exceeding 100.
  • Many overdose deaths involved co-ingestion of multiple substances.
  • The majority of individuals prescribed MME >100/day received a prescription within 90 days of their overdose.

Conclusions:

  • State PMP medication profiles are valuable for identifying prescription dosing patterns associated with drug overdose fatalities.
  • High-dose opioid prescribing (MME >100/day) is a critical risk factor for prescription drug overdose death.