Pharmacoepidemiology and drug safety
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Pharmacoepidemiol Drug Saf · Jan 2019
Impact of initiatives to reduce prescription opioid risks on medically attended injuries in people using chronic opioid therapy.
The purpose of the study is to determine whether initiatives to improve the safety of opioid prescribing decreased injuries in people using chronic opioid therapy (COT). ⋯ Risk reduction initiatives did not decrease injuries in people using COT.
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Increasing use of tramadol for chronic non-cancer pain is concerning since tramadol users may be at risk of developing recurrent opioid use with increasing opioid consumption and co-medication. Therefore, we investigated a complete national cohort of tramadol users. ⋯ Many patients who developed recurrent opioid use received prescriptions which substantially conflicted with existing guidelines and might lead to problematic opioid use.
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Pharmacoepidemiol Drug Saf · Jan 2019
Scoring the best deal: Quantity discounts and street price variation of diverted oxycodone and oxymorphone.
Diverted prescription opioids are significant contributors to drug overdose mortality. Street price has been suggested as an economic metric of the diverted prescription opioid black market. This study examined variables that may influence the street price of diverted oxycodone and oxymorphone. ⋯ Street prices for diverted oxycodone and oxymorphone are influenced by multiple factors including potency, dosage, formulation, and bulk purchasing. Buyers who purchase large quantities of low potency, large dosage, crush-resistant formulation prescription opioids can expect to achieve the lowest price.
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Pharmacoepidemiol Drug Saf · Jan 2019
Opioid tolerance and clinically recognized opioid poisoning among patients prescribed extended-release long-acting opioids.
In recognition of potential for increased overdose risk, drug labels for extended-release and long-acting (ER/LA) opioids emphasize the need for established opioid tolerance prior to initiating high dosages. ⋯ Over one-third of patients initiating ≥90 MME ER/LA opioids did not have evidence of opioid tolerance. The 7 days following high dose ER/LA initiation may represent a high-risk period for clinically diagnosed opioid poisoning in patients who do not have prior opioid tolerance.