Abuse of Weak Opioid Analgesics

Lader, M. H.

doi:10.1177/096032718400300120

Cited by 7 publications

(1 citation statement)

References 20 publications

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“…The mostly widely known serious side effect of propoxyphene is cardiotoxicity leading to potentially fatal arrhythmias . Propoxyphene has also been associated with dependency, abuse, and overdoses leading to hospitalization and death . Per 100 000 prescriptions, propoxyphene was linked to more drug‐related deaths than either hydrocodone or tramadol and more emergency department visits than codeine…”

Section: Introductionmentioning

confidence: 99%

The influence of propoxyphene withdrawal on opioid use in veterans

Hayes

Hudson

Phillips

et al. 2015

Pharmacoepidemiol Drug Saf

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Purpose To determine if propoxyphene withdrawal from the U.S. market was associated with opioid continuation, continued chronic opioid use and secondary propoxyphene related adverse events (emergency department visits, opioid-related events, and acetaminophen toxicity). Methods Medical service use and pharmacy data from 11/19/08 to 11/19/11 were collected from the national Veterans Healthcare Administration (VHA) healthcare databases. A quasi-experimental pre-post retrospective cohort design utilizing a historical comparison group provided the study framework. Logistic regression controlling for baseline covariates was used to estimate the effect of propoxyphene withdrawal. Results There were 24,328 subjects (policy-affected n=10,747; comparison n=13,581) meeting inclusion criteria. In the policy-affected cohort, 10.6% of users ceased using opioids and 26.6% stopped chronic opioid use compared to 3.8% and 13.5% in the historical comparison cohort respectively. Those in the policy-affected cohort were 2.7 (95%CI: 2.5–2.8) and 3.2 (95%CI: 2.9–3.6) times more likely than those in the historical comparison cohort to discontinue chronic opioid and any opioid use respectively. Changes in adverse events and ED visits were not different between policy affected and historical comparison cohorts (p>0.05). Conclusions The withdrawal of propoxyphene containing products resulted in rapid and virtually complete elimination in propoxyphene prescribing in the Veterans population; however, nearly 90% of regular users of propoxyphene switched to an alternate opioid and three quarters continued to use opioids chronically.

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Section: Introductionmentioning

confidence: 99%