• J Gen Intern Med · Mar 2020

    Opioid Prescriptions and Short-Term Mortality: a U.S. National Study.

    • Alicia Agnoli, Anthony Jerant, William Becker, and Peter Franks.
    • Department of Family and Community Medicine , UC Davis School of Medicine, Sacramento, CA, USA. aagnoli@ucdavis.edu.
    • J Gen Intern Med. 2020 Mar 1; 35 (3): 656-661.

    BackgroundOpioid-related mortality continues to rise. Though risks of prescription opioid misuse and abuse are well known, short-term mortality across a range of prescription opioid exposure is unclear.ObjectiveThis study was conducted in order to assess the short-term mortality associated with quantity of reported opioid prescriptions, DESIGN: An observational analysis was performed using data from the Medical Expenditure Panel Survey, years 2005-2015, a population-based, nationally representative household survey.ParticipantsThis study included adults (age 18+) with prescription data and death status reported during their 2-year survey participation.Main MeasuresKey exposure is the number of opioid prescriptions (0, 1-5, 6 or more) in year 1 of survey participation. The main outcome is all-cause mortality reported during the 2-year survey participation.Key ResultsOf 90,622 participants, 14% reported at least 1 opioid prescription. There were 774 (0.9%) deaths during the survey period, 551 (0.7%) among those not reporting opioids, 127 (1.2%) among those reporting 1-5 opioid prescriptions, and 96 (3.9%) among those reporting 6 or more opioid prescriptions. After adjusting for sociodemographics, health status, and utilization, there was no significant association between category of opioid prescriptions and death during the study period; adjusted odds ratios = 0.86 (95% CI = 0.66, 1.22, p = 0.27) and 0.99 (95% CI = 0.74, 1.34, p = 0.96), respectively, for 1-5 prescriptions and 6 or more prescriptions.ConclusionsIn a nationally representative sample, opioid prescriptions were associated with increased short-term mortality only without adjustment for sociodemographics, health status, or utilization. The relationship between prescription opioid use and mortality risk is more complex than previously reported, meriting further examination.

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