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New Alcohol-related Condition Diagnoses Are Associated With Opioid Tapers Among Patients Receiving Long-term Opioid Therapy

  • 0From the Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO (JDP, IAB); Department of Medicine, Denver Health Hospital Authority, Denver, CO (JDP); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (JDP, KJN, APN, JMG, IAB); Department of Epidemiology, Colorado School of Public Health, Aurora, CO (JMG); Chemical Dependency Treatment Services, Colorado Permanente Medical Group, Denver, CO (IAB); and Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA (IAB).
Journal of Addiction Medicine +

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November 26, 2024

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November 26, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Patients on decreasing long-term opioid therapy (LTOT) doses face a higher risk of developing new alcohol-related conditions (ARCs). Routine screening for alcohol use during LTOT tapers can aid early detection and intervention.

Area Of Science

  • Pain Management
  • Addiction Medicine
  • Public Health

Background

  • Chronic pain patients often receive long-term opioid therapy (LTOT).
  • Alcohol-related conditions (ARCs) are a concern in this population.
  • Understanding the interplay between LTOT dose changes and ARCs is crucial.

Purpose Of The Study

  • To examine the association between ARCs and LTOT dose trajectories.
  • To investigate if ARCs moderate the link between LTOT tapers and mortality.

Main Methods

  • Retrospective cohort study of 3912 patients on LTOT.
  • Multinomial regression for ARC association with LTOT dose.
  • Competing risks regression for LTOT trajectories and new ARCs.
  • Cox-proportional hazards models for mortality moderation.

Main Results

  • 6.2% of patients had pre-existing ARCs; no association with LTOT trajectory.
  • Patients on decreasing LTOT doses were twice as likely to develop new ARCs (aHR 2.23).
  • ARCs did not significantly moderate the LTOT trajectory-mortality relationship.

Conclusions

  • Decreasing LTOT dose trajectories increase the risk of new ARCs.
  • Routine alcohol use screening is recommended for patients tapering LTOT.
  • Interventions to reduce alcohol use may mitigate LTOT taper-related harms.

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