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Higher daily doses of opioid therapy associated with lower mortality in HIV and uninfected patients
Publication year - 2020
Publication title -
alcoholism and drug abuse weekly
Language(s) - English
Resource type - Journals
eISSN - 1556-7591
pISSN - 1042-1394
DOI - 10.1002/adaw.32836
Subject(s) - medicine , buprenorphine , methadone , opioid , benzodiazepine , morphine , drug overdose , drug , opioid overdose , heroin , anesthesia , emergency medicine , pharmacology , poison control , (+) naloxone , receptor
People with HIV, as well as those who are uninfected, do well on long‐term treatment with opioids (methadone or buprenorphine), researchers have found. There is a strong dose‐response relationship between mortality (all causes), unnatural death and overdose, with the higher morphine equivalent daily doses having the best outcomes, according to the study, by Ajay Manhapra, M.D., and colleagues and published online Sept. 16 in the Journal of Drug and Alcohol Dependence . “Opioid risk mitigation approaches should be expanded to address the potential effects of higher dose on all‐cause mortality in addition to unnatural and overdose fatalities,” the researchers conclude in the abstract. For the study, there were 22,996 patients on long‐term treatment, 6,578 (29%) with HIV and 16,418 (71%) uninfected. Among 5,222 (23%) deaths, 12% were unnatural deaths and 6% overdoses. The study, “All‐cause mortality among males living with and without HIV initiating long‐term opioid therapy, and its association with opioid dose, opioid interruption and other factors,” also found that benzodiazepine use was associated with overdose.