Association of Dose Tapering With Overdose or Mental Health Crisis Among Patients Prescribed Long-term Opioids
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View abstract on PubMed
Summary
This summary is machine-generated.Opioid dose tapering in patients on long-term therapy was linked to higher rates of overdose and mental health crises. These findings highlight potential risks associated with reducing opioid dosages, emphasizing the need for careful patient management.
Area Of Science
- Pain Management
- Public Health
- Clinical Pharmacology
Background
- National guidelines and opioid-related mortality have prompted dose tapering for patients on long-term opioid therapy.
- Limited data exists on the risks of opioid tapering, including overdose and mental health crises.
Purpose Of The Study
- To investigate the association between opioid dose tapering and the incidence of overdose and mental health crises in patients on stable, long-term, higher-dose opioid therapy.
Main Methods
- Retrospective cohort study utilizing deidentified medical and pharmacy claims data (2008-2019).
- Included adults with stable higher-dose opioid prescriptions (≥50 MME/d) for at least 12 months.
- Opioid tapering defined as ≥15% relative dose reduction over 60-day windows; outcomes assessed via regression models.
Main Results
- Opioid tapering was associated with a significantly increased rate of overdose (aIRR, 1.68) and mental health crisis (aIRR, 2.28).
- Faster dose reduction velocity correlated with higher risks of both overdose and mental health crisis.
- The study analyzed 203,920 stable baseline periods in 113,618 patients.
Conclusions
- Opioid dose tapering in patients on long-term, higher-dose therapy is significantly associated with increased risks of overdose and mental health crisis.
- Findings suggest potential harms of tapering, warranting careful consideration in clinical practice.
- Interpretation is limited by the observational nature of the study design.
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