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All-Cause and Overdose Mortality Risk Among People Prescribed Opioids: A Systematic Review and Meta-analysis.

Sarah Larney1,2, Amy Peacock2, Lucy T Tran2

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Pain Medicine (Malden, Mass.)
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PubMed
Summary
This summary is machine-generated.

Opioid prescribing for chronic pain is associated with significant all-cause and overdose mortality rates. Methodological limitations hinder precise risk assessment, necessitating large-scale trials for better understanding of opioid safety in pain management.

Keywords:
Chronic Non-Cancer PainMortalityOpioidsOverdosePoisoning

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Area of Science:

  • Medical Research
  • Public Health
  • Pharmacology

Background:

  • Opioid analgesics are widely prescribed for chronic noncancer pain.
  • Concerns exist regarding the mortality risks associated with long-term opioid use.
  • Evidence on overdose death risk among patients on chronic opioid therapy is limited.

Purpose of the Study:

  • To estimate all-cause and overdose mortality rates in individuals prescribed opioids for chronic noncancer pain.
  • To compare overdose death risk in this population versus similar individuals not prescribed opioids.

Main Methods:

  • Systematic review and meta-analysis of cohort studies published from 2009 onwards.
  • Searched Medline, Embase, and PsycINFO databases.
  • Included 13 cohorts with over 6 million participants, excluding those with opioid use disorder or cancer-related pain.

Main Results:

  • Pooled all-cause crude mortality rate was 28.8 per 1000 person-years (substantial heterogeneity).
  • Pooled overdose crude mortality rate was 1.1 per 1000 person-years (substantial heterogeneity; poor ascertainment of opioid exposure).
  • Could not estimate relative overdose risk compared to non-opioid-prescribed populations.

Conclusions:

  • Methodological limitations in current literature impede accurate determination of overdose mortality risk.
  • There is a critical need for large-scale clinical trials to evaluate adverse outcomes of opioid prescribing for chronic noncancer pain.