Jessica Gregg, MD, PhD
This article was published online first at www.annals.org on 29 December 2015.
Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2687.
Requests for Single Reprints: Jessica Gregg, MD, PhD, Central City Concern, 1535 North Williams Avenue, Portland, OR 97232; e-mail, firstname.lastname@example.org.
Gregg J. Follow-up to Nonfatal Opioid Overdoses: More of the Same or an Opportunity for Change?. Ann Intern Med. 2016;164:62-63. doi: 10.7326/M15-2687
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Published: Ann Intern Med. 2016;164(1):62-63.
Published at www.annals.org on 29 December 2015
More than 90% of patients who survive a prescription opioid overdose continue to be prescribed opioids after the event, usually by the same prescriber. This is the astonishing finding of the study by Larochelle and colleagues (1) published in this issue. Using the Optum database of claims for a large national insurer, the authors found that among 2848 patients who survived an overdose on opioids prescribed for chronic noncancer pain, 91% continued to receive opioid prescriptions.
Prescribing guidelines are clear that adverse events, such as overdose, are compelling reasons to withdraw prescription opioids (2). Therefore, it is tempting, and would be easy, to attribute these results to poor care, bad decisions, or sloppy prescribing. However, the problem goes well beyond individual prescribers' practices. These prescribing behaviors occur in a context in which substantial—even deadly—mistakes are inevitable.
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Emergency Medicine, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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