ArticleAddiction (Abingdon, England)2022
Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions.
Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Pooled it
- Evaluating risk factors and protective clinical interventions for opioid use disorder and overdose in American Indian/Alaska Native populations.Journal of ethnicity in substance abuse · 2026Article
- Identifying emergency department patients at high risk for opioid overdose using natural language processing and machine learning.Journal of substance use and addiction treatment · 2025Article
- Opioid prescription patterns and pain severity among patients with opioid use disorder and other substance use disorders: a mixed methods study.Pain reports · 2025Article
- The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis.Addiction (Abingdon, England) · 2025Article
- Risks of opioid overdose among New York State Medicaid recipients with chronic pain before and during the COVID-19 pandemic.Preventive medicine · 2023Article
- Associations between naloxone prescribing and opioid overdose among patients with acute and chronic pain conditions.Addiction (Abingdon, England) · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
aimsTo assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose.
designA retrospective cohort study using data from the Health Facts Database.
settingOver 600 United States healthcare facilities.
participantsThree patient groups were followed for 2 years during 2009 to 2017: individuals with shoulder or long bone fractures (n = 252 424), chronic pain syndrome (CPS) (n = 76 141), or non-traumatic low back pain (n = 792 956) who received an opioid prescription. Groups were chosen based on previous work. MEASUREMENTS: The outcome was opioid overdose identified by International Classification of Diseases codes (ICDs) and the primary predictor was number of naloxone prescriptions identified by National Drug Codes (NDCs).
findingsOpioid overdoses occurred among 0.16% of fracture patients (average follow-up time to overdose [AFU] = 240 days), 1.28% of CPS patients (AFU = 244 days), and 0.30% low back pain patients (AFU = 264 days). A total of 58 083 bone fracture patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (hazard ratio [HR] = 1.87, 95% CI = 1.68-2.09), and number of subsequent overdoses (incidence rate ratio [IRR] = 1.89, 95% CI = 1.69-2.12). A total of 19 529 CPS patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.69, 95% CI = 1.61-1.78) and number of subsequent overdoses (IRR = 1.74, 95% CI = 1.67-1.83). A total of 110 608 low back pain patients received naloxone prescriptions, and naloxone prescription was associated with subsequent opioid overdose (HR = 1.33, 95% CI = 1.27-1.40) and number of subsequent overdoses (IRR = 1.35, 95% CI = 1.29-1.41).
conclusionsReceiving a naloxone prescription appears to be associated with increased risk of subsequent opioid overdose among patients with acute and chronic pain, suggesting prescribers often identify patients most in need of naloxone.
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