Open AccessReducing Opioid Analgesic Deaths in America: What Health Providers Can Do
Author(s) -
Taghogho Agarin,
Andrea M. Trescot,
Aniefiok Agarin,
Doreena Lesanics,
Claricio Decastro
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj/2015.18.e307
Subject(s) - medicine , analgesic , medline , opioid related disorders , opioid , chronic pain , intensive care medicine , medical prescription , anesthesia , psychiatry , pharmacology , opioid epidemic , receptor , political science , law
Background: Available data have shown steady increases of drug overdose deaths between1992 and 2011. We review evidenced-based recommendations provided by a few prominentNorth American pain societies and suggest ways on how health providers might help reduceopioid analgesic deaths by implementing these practices.Objective: To identify health care providers’ roles in reducing opioid analgesic deaths.Study Design: A comprehensive review of current literature.Methods: The review included relevant literature identified through searches of MEDLINE,Cochran reviews, and Google Scholar, PubMed and EMBASE from January 1998 to January2014. The level of evidence was classified as I (good), II (fair), and III (limited) based on thequality of evidence developed by the U.S. Preventive Services Task Force (USPSTF).Results: Several practices such as too high doses overall, giving too high doses to opioidnaive patients, too fast opioid titration, insufficient use and knowledge of urine drug testing,not updating knowledge of drug metabolism/interactions, and inadequate patient monitoringare associated with higher risks of opioid analgesic deaths. Suboptimal risk stratification ofpatients, rotation practices, and use of opioids analgesics in chronic noncancer pain are alsoassociated factors.Limitations: There were a paucity of good evidence studies which show recommendationsreduce death.Conclusion: Providers should be aware of all associated factors with opiate analgesic deathsand apply the available evidence in reducing opioid analgesic deaths.Key words: Opioid analgesic deaths, methadone deaths, opioid mortality, opioid guidelines,genetic testing for opioids, urine drug testing