ArticlePain2022
Patient outcomes after opioid dose reduction among patients with chronic opioid therapy.
Article in Pain, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Pooled it
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Care Models to Improve Pain and Reduce Opioids Among Patients Prescribed Long-Term Opioid Therapy: The VOICE Randomized Clinical Trial.JAMA internal medicine · 2025Trial
- Pain and Opioid Dose Reduction Based on Substance Use Disorder Status: Secondary Analysis from a Pragmatic Effectiveness Trial.Journal of general internal medicine · 2026Article
- Prescription opioid discontinuation and mortality due to suicide or unintentional overdose.Pain · 2026Article
- Trends in acupuncture billing by a large commercial insurer.The American journal of managed care · 2026Article
- Dose trajectories associated with non-fatal overdose among patients co-prescribed opioids and benzodiazepines: Retrospective cohort study.Drug and alcohol dependence · 2025Article
- Do Communities Implementing the Communities That HEAL Intervention Have Significantly Lower Rates of High-Risk Opioid Prescribing and Dispensing?AJPM focus · 2025Article
- A qualitative interview study exploring the experiences of pain specialists on prescribing opioids for chronic non-cancer pain.Scientific reports · 2025Article
- Association between rapid opioid reduction or discontinuation and self-harm, suicide attempt, and suicide death among patients receiving high-dose, long-term opioid therapy in North Carolina, 2006-2018.American journal of epidemiology · 2025Article
- Implementation interventions to promote healthcare professional uptake of evidence-based opioid deprescribing for adults with chronic non-cancer pain.The Cochrane database of systematic reviews · 2025Article
- Development of the barriers to opioid access scale among individuals with chronic pain.Exploratory research in clinical and social pharmacy · 2025Article
- Two-Phase Inpatient Withdrawal Programme for Long-Term Opioid Use in Non-Cancer Pain.European journal of pain (London, England) · 2025Observational
- Unsupervised machine learning identifies opioid taper reversal patterns in a longitudinal cohort (2008-2018).PLOS digital health · 2025Article
- Sociogeographic determinants of rapid opioid reduction or discontinuation among patients on high-dose long-term opioid therapy in North Carolina, 2006-2018.Pain medicine (Malden, Mass.) · 2025Article
- Outcomes After a Statewide Policy to Improve Evidence-Based Treatment of Back Pain Among Medicaid Enrollees in Oregon.Journal of general internal medicine · 2025Article
- Chronic Opioid Use After Implementation of Oregon's Medicaid Back Pain Policy.American journal of preventive medicine · 2025Article
- Article
- "The Fact [Is] That There Is No Easy Way". A Qualitative Study of the Experiences of Aotearoa New Zealand Clinicians with Opioid Tapering for Chronic Non-Cancer Pain.Journal of pain research · 2025Article
- Pharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.Journal of clinical medicine · 2024Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
abstractThe net effects of prescribing initiatives that encourage dose reductions are uncertain. We examined whether rapid dose reduction after high-dose chronic opioid therapy (COT) associates with suicide, overdose, or other opioid-related adverse events. This retrospective cohort study included Oregon Medicaid recipients with high-dose COT. Claims were linked with prescription data from the prescription drug monitoring program and death data from vital statistics, 2014 to 2017. Participants were placed into 4 mutually exclusive dose trajectory groups after the high-dose COT period, and Cox proportional hazard models were used to examine the effect of dose changes on patient outcomes in the following year. Of the 14,596 high-dose COT patients, 4191 (28.7%) abruptly discontinued opioid prescriptions, 1648 (11.3%) reduced opioid dose before discontinuing, 6480 (44.4%) had a dose reduction but never discontinued, and 2277 (15.6%) had a stable or increasing dose. Discontinuation, whether abrupt (adjusted hazard ratio [aHR] 3.63; 95% confidence interval [CI] 1.42-9.25) or with dose reduction (aHR 4.47, 95% CI 1.68-11.88) significantly increased risk of suicide compared with those with stable or increasing dose. By contrast, discontinuation or dose reduction reduced the risk of overdose compared with those with a stable or increasing dose (aHR 0.36-0.62, 95% CI 0.20-0.94). Patients with an abrupt discontinuation were more likely to overdose on heroin (vs. prescription opioids) than patients in other groups (P < 0.0001). Our study suggests that patients on COT require careful risk assessment and supportive interventions when considering opioid discontinuation or continuation at a high dose.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.