ArticleAddiction (Abingdon, England)2018
Risk factors for severe respiratory depression from prescription opioid overdose.
Article in Addiction (Abingdon, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- A systematic analysis and data mining of opioid-related adverse events submitted to the FAERS database.Experimental biology and medicine (Maywood, N.J.) · 2023Pooled it
- Effect of nerve block combined with superficial general anaesthesia on anaesthetic dosage and anaesthetic awakening in paediatric surgery.BMC anesthesiology · 2025Trial
- Safety, Tolerability, and Dose Proportionality of a Novel Transdermal Fentanyl Matrix Patch and Bioequivalence With a Matrix Fentanyl Patch: Two Phase 1 Single-Center Open-Label, Randomized Crossover Studies in Healthy Japanese Volunteers.Clinical pharmacology in drug development · 2021Trial
- Fentanyl Initiation Rate Following the Requirement for Specialist Approval.Journal of general internal medicine · 2025Observational
- Short-term mortality after opioid initiation among opioid-naïve and non-naïve patients with dementia: a retrospective cohort study.BMC medicine · 2025Article
- Factors Associated with Attempted Suicide Among Emergency Department Patients with Nonfatal Opioid Overdose.Substance use & misuse · 2025Observational
- A pilot study to identify pharmacogenomic and clinical risk factors associated with opioid related falls and adverse effects in older adults.Clinical and translational science · 2023Observational
- Piloting Smart Home Sensors to Detect Overnight Respiratory and Withdrawal Symptoms in Adults Prescribed Opioids.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2023Article
- An integrated LSTM-HeteroRGNN model for interpretable opioid overdose risk prediction.Artificial intelligence in medicine · 2023Article
- Modeling of overdose and naloxone distribution in the setting of fentanyl compared to heroin.Drug and alcohol dependence · 2022Article
- Opioid Dosage Levels, Concurrent Risk Factors and Self-Perceptions among Chronic Pain, Opioid-Managed Individuals at Elevated Risk for Opioid Overdose.Pharmaceuticals (Basel, Switzerland) · 2021Article
- Prescription opioid policies and associations with opioid overdose and related adverse effects.The International journal on drug policy · 2021Article
- Time-Dependent Changes in the Serum Levels of Neurobiochemical Factors After Acute Methadone Overdose in Adolescent Male Rat.Cellular and molecular neurobiology · 2021Article
- Co-ingestion of prescription drugs and alcohol in US adults aged 50 years or older.Human psychopharmacology · 2021Article
- A Large-Scale Observational Study on the Temporal Trends and Risk Factors of Opioid Overdose: Real-World Evidence for Better Opioids.Drugs - real world outcomes · 2021Article
- γ-Hydroxybutyric Acid: Pharmacokinetics, Pharmacodynamics, and Toxicology.The AAPS journal · 2021Review
- The molecular neurobiology and neuropathology of opioid use disorder.Current research in neurobiology · 2021Article
- Monoclonal Antibodies Counteract Opioid-Induced Behavioral and Toxic Effects in Mice and Rats.The Journal of pharmacology and experimental therapeutics · 2020Article
- Article
- Emergency Department Visits for Opioid Overdoses Among Patients With Cancer.Journal of the National Cancer Institute · 2020Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsPrescription opioid overdose is a leading cause of injury-related morbidity and mortality in the United States. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose.
designThis was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD).
settingThis study was conducted at two urban academic emergency departments in New York City, USA.
participantsAdult patients who presented with acute prescription opioid overdose between 2009 and 2013 were included in the current study. We analyzed 307 patients (mean age = 44.7, 42% female, 2.0% mortality). MEASUREMENTS: Patient demographics, reported substances ingested, suspected intent for ingesting the substance, vital signs, laboratory data, treatments including antidotes and intubation and outcome of death were recorded by trained research assistants. Intent was categorized into four mutually exclusive categories: suicide, misuse, therapeutic error and undetermined. The primary outcome was SRD, defined as administration of either (a) naloxone or (b) endotracheal intubation (ETI).
findingsA total of 109 patients suffered SRD with 90 patients receiving naloxone alone, nine ETI alone and 10 both naloxone and ETI. The most common opioids were oxycodone (n = 124) and methadone (n = 116). Mean age was higher in patients with SRD (51.1 versus 41.1, P < 0.001). Opioid misuse was associated with SRD in the multivariable analysis [odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.21-3.55]. The unadjusted relative risk of SRD was high for fentanyl (83.3% SRD) and lowest for codeine (3.6% SRD).
conclusionIn emergency department patients in the United States with prescription opioid overdose, worse clinical severity was associated with opioid misuse, increased with age and was widely variable, depending on the specific opioid medication involved.
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