Chronic Pain Conditions, Mental Health Disorders Put People At Highest Risk For Opioid-Related Overdose Death
According to a study of over 13,000 overdose deaths, more than half of the decedents who had overdosed on opioids had been diagnosed with chronic pain conditions, and many had a co-occurring mental health disorder. Interestingly, however, rarely had these people received a diagnosis of opioid use disorder.
For the study, investigators at Columbia University Medical Center wanted to better characterize persons who suffered from chronic pain and died of an opioid-related overdose. The examined clinical diagnoses and medication prescriptions for adults in the Medicaid program with opioid overdose listed as the cause of death.
Lead author Mark Olfson, M.D., as quoted in a press release:
“The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems.”
Around more than one-third of the individuals who died had been diagnosed with a substance use disorder in the past year (40.8%.) And yet, less than one in 20 had been specifically diagnosed with an opioid use disorder in the past month.
Decedents were also much more likely than a non-pain group to be diagnosed with depression (29.6% vs. 13%) or anxiety (25.8% vs. 8.4%) in the last year of life.
Olfson also stated that “because clinical diagnoses generally indicate treatment” this pattern suggests that before they fatally overdose, many people have dropped out of drug treatment. He said that improving the retention of these patients may help reduce the risk of overdose death.
Also, in the month before their deaths, about half of the decedents filled prescriptions for opioids (49%) or benzodiazepines (52%), and many filled prescriptions for both.
“This medication combination is known to increase the risk of respiratory depression, which is the unusually slow and shallow breathing that is the primary cause of death in most fatal opioid overdoses.”
Therefore, researchers advised health providers to limit prescriptions for this combination, and prescribe the lowest possible dose and duration.
~ G. Nathalee Serrels, M.A., Psychology