Evidence map›Paper›PMID 39432978›Full record

ArticleThe International journal on drug policy2024

The role of prescribed controlled substance acquisition as potential triggers of opioid overdose: A case-crossover study.

Allen M Smith, Cheng Peng, Austin Porter, Bradley C Martin

Abstract read
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Article in The International journal on drug policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Allen M SmithDivision of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA.
Cheng PengDivision of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA.
Austin PorterDepartment of Health Policy and Management, University of Arkansas for Medical Sciences College of Medicine, 4301 W. Markham St., Little Rock, AR, 72205, USA; Arkansas Department of Health, 4815 W. Markham St., Little Rock, AR, 72205, USA.
Bradley C MartinDivision of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA. Electronic address: bmartin@uams.edu.

Funding

Translational Training in AddictionT32DA022981 · NIDA · UNIV OF ARKANSAS FOR MED SCIS · PI Melissa Jean Zielinski · 2009 to 2026
$6.1M
NIDA NIH HHS T32 DA022981NIH HHS 5T32 DA022981–14
6 · The paper itself

Abstract

backgroundThe role of prescribed opioids and benzodiazepines as risk factors for opioid overdose are well established, however, their role as potential 'triggers' of opioid overdose has not been formally investigated.

objectiveThe objective of this study was to evaluate the temporal relationship between controlled substance acquisition and opioid overdose utilizing a case-crossover design.

methodsThis study utilized Arkansas statewide data between 2014 and 2020. Prescription Drug Monitoring Program (PDMP) data were used to assess controlled substance acquisition and fatal and non-fatal opioid overdose were assessed using linked death certificate, inpatient discharge, and emergency department (ED) data. All persons residing in Arkansas who experienced an opioid overdose or had ≥ 1 Arkansas PDMP prescription fill(s) were included. Controlled substance characteristics were described in the 7 days prior to overdose and compared to the controlled substance characteristics in 11 weekly (7-day) control windows prior to overdose. Binary controlled substance variables indicating presence or absence of: any controlled substance, opioid, benzodiazepine, stimulant, sedative, carisoprodol, opioid and benzodiazepine, and opioid and benzodiazepine and carisoprodol were created. Additionally, total morphine milliequivalents were calculated for each time window. Conditional logistic regression models were estimated and adjusted odds ratios for each controlled substance characteristic after accounting for other controlled substance, and prior overdose, and clinical characteristics derived from ED and inpatient data are reported.

resultsA total of 2,818,135 individuals with ≥1 Arkansas PDMP record(s) (45.10 % male; 39.94 mean age) were included, of which 28,670 (1.02 %) experienced ≥1 opioid overdose. There was a significant association between opioid overdose and the acquisition of a controlled substance (OR=1.785; p < 0.001), opioid (OR=1.992; p < 0.001), benzodiazepine (OR=1.379; p < 0.001), carisoprodol (OR=1.744; p < 0.001), opioid and benzodiazepine (OR=2.203; p < 0.001), and opioid and benzodiazepine and carisoprodol (OR=2.503; p < 0.001), in the 7 days prior to an opioid overdose event.

conclusionControlled substance prescription acquisition, particularly opioids in combination with carisoprodol and/or benzodiazepines, are potential triggers of opioid overdose.

Indexed as

Analgesics, OpioidCross-Over StudiesOpiate OverdoseAdolescentAdultArkansasBenzodiazepinesControlled SubstancesDrug OverdoseFemaleHumansMaleMiddle AgedPrescription Drug MisusePrescription Drug Monitoring ProgramsRisk FactorsAnalgesics, OpioidBenzodiazepinesControlled SubstancesArkansas Department of HealthArkansas prescription drug monitoring programCase-crossover studyControlled substance acquisitionOpioid overdoseOverdose triggers

Identifiers

PMID39432978
PMCPMC13033341

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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.