McMaster researcher identifies 10 predictors of opioid overdose after prescription

What factors make an individual at a greater risk of opioid overdose after being prescribed the medication? A new study led by a McMaster University researcher has helped identify 10 predictors that show large associations with opioid overdose.

The predictors were identified as part of a large-scale study published in the Canadian Medical Association Journal (CMAJ). Li Wang, an associate professor with McMaster’s Department of Anesthesia, and a researcher and methodologist at the Michael G. DeGroote Institute for Pain Research and Care, says an awareness of these predictors can help the public and providers better understand the risks of overdose when deciding whether opioids should be used for chronic pain.

“The opioid crisis has generated interest in identifying patients at higher risk of addiction or overdose and led to the development of several screening tools,” Wang says. “However, these instruments have either not been validated or shown poor validity and reliability

The study found the risk of opioid overdose, both fatal and nonfatal, after prescription was two- to six-fold with high-dose opioids, fentanyl prescription, multiple opioid prescribers or pharmacies, history of overdose, current substance use disorder, depression, bipolar disorder, other mental illness, or pancreatitis.

“Our findings suggest that awareness of, and attention to, several patient and prescription characteristics, may help reduce the risk of opioid overdose among people living with chronic pain.”

As part of their work, researchers examined 28 studies that included 24 million patients from Canada, the United Kingdom, and the United States. The patients had been prescribed opioids for non-cancer and cancer-related chronic pain.

The study was published on Oct. 23. It was funded in part by a grant from Health Canada’s Substance Use and Addictions Program.