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

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Abstract

Background: Opioid-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. Objective: This 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. Participants: This study included adults (age 18+) with prescription data and death status reported during their 2-year survey participation. Main Measures: Key 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 Results: Of 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. Conclusions: In 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.

Original languageEnglish (US)
JournalJournal of general internal medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Opioid Analgesics
Prescriptions
Mortality
Health Status
Health Expenditures
Surveys and Questionnaires
Odds Ratio

Keywords

  • health status
  • mortality
  • opioids
  • pain
  • United States

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{2e9ceb11d83b48248e1cf1e714ef31ae,
title = "Opioid Prescriptions and Short-Term Mortality: a U.S. National Study",
abstract = "Background: Opioid-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. Objective: This 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. Participants: This study included adults (age 18+) with prescription data and death status reported during their 2-year survey participation. Main Measures: Key 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 Results: Of 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. Conclusions: In 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.",
keywords = "health status, mortality, opioids, pain, United States",
author = "Alicia Agnoli and Anthony Jerant and William Becker and Peter Franks",
year = "2019",
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T1 - Opioid Prescriptions and Short-Term Mortality

T2 - a U.S. National Study

AU - Agnoli, Alicia

AU - Jerant, Anthony

AU - Becker, William

AU - Franks, Peter

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Opioid-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. Objective: This 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. Participants: This study included adults (age 18+) with prescription data and death status reported during their 2-year survey participation. Main Measures: Key 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 Results: Of 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. Conclusions: In 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.

AB - Background: Opioid-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. Objective: This 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. Participants: This study included adults (age 18+) with prescription data and death status reported during their 2-year survey participation. Main Measures: Key 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 Results: Of 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. Conclusions: In 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.

KW - health status

KW - mortality

KW - opioids

KW - pain

KW - United States

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U2 - 10.1007/s11606-019-05501-w

DO - 10.1007/s11606-019-05501-w

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