Patients with chronic pain can have an increased risk of medication overdose due to comorbid psychiatric disorders or pain and its treatment with prescription drugs such as opioids which can increase overdose risk.
Our recently published study examined fatal overdoses and associated factors among individuals who had been pharmacologically treated for chronic pain. All individuals who were dispensed analgesics for chronic pain through a reimbursed prescription in Norway between 2010-2019 were included in the study. Further, we identified all individuals among them with overdose as the cause of death.
A total of 623 (0.11%) individuals in the study population died from an overdose. The majority (66.8%) had accidentally overdosed and 61.9% were a result of prescription opioids. Overdoses overall were strongly associated with previous substance use disorder diagnoses, prescription of combinations of opioids, benzodiazepines and gabapentinoids, previous drug poisonings, and living alone in the last year of life. Intentional overdoses (suicide) had a stronger association with previous drug poisonings than accidental overdoses, which were strongly associated with substance use disorder diagnoses.
Our study highlights the need for better identification of overdose and suicide risk in individuals pharmacologically treated for chronic pain. Extra caution is necessary when treating complex comorbid mental disorders, especially with multiple addictive medications in combination.
This work is a part of the POINT project. For more information, contact Svetlana Skurtveit (+47 41103614)
Fatal drug overdoses in individuals treated pharmacologically for chronic pain: a nationwide register-based study. Aleksi Hamina, Ingvild Odsbu, Vidar Hjellvik, Torgeir G. Lid, Thomas Clausen og Svetlana Skurtveit. British Journal of Anaesthesia.2023.