Impact of opioid dose escalation on the development of substance use disorders, accidents, self-inflicted injuries, opioid overdoses and alcohol and non-opioid drug-related overdoses: a retrospective cohort study.

ABSTRACT:

Aim

To understand the potential harmful effects of dose escalation among patients with chronic, non-cancer pain (CNCP) on chronic opioid therapy.

Design

Retrospective cohort study.

Setting

United States Veterans Healthcare Administration.

Participants

Veterans with CNCP and on chronic opioid therapy were identified using data from fiscal years 2008-15. The Veteran sample was approximately 90% male and 70% white.

Measurements

Dose escalators [increase of > 20% average morphine milligram equivalent (MME) daily dose] were compared with dose maintainers (change of ±20% average MME daily dose). A composite measure of subsequent substance use disorders (SUDs: opioid, non-opioid and alcohol use disorders) and opioid-related adverse outcomes (AOs: accidents resu

SUBMITTER: Hayes CJ 

PROVIDER: S-EPMC7263736 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature