The Burden of Opioid-Related Mortality in the United States

Gomes, Tara; Tadrous, Mina; Mamdani, Muhammad; Paterson, J. Michael; Juurlink, David N.

doi:10.1001/jamanetworkopen.2018.0217

Cited by 522 publications

(378 citation statements)

References 5 publications

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“…These concerns need to be balanced with the need to treat chronic pain. A recent review of deaths from opioids concluded that the burden of opioid overdose in older adults requires special attention, noting the largest relative increase in opioids occurred in persons 55 to 64 (754% increase from 0.2% to 1.7%) and 65 years and older and the absolute number of deaths in this group is moderate …”

Section: Discussionmentioning

confidence: 99%

“…A recent review of deaths from opioids concluded that the burden of opioid overdose in older adults requires special attention, noting the largest relative increase in opioids occurred in persons 55 to 64 (754% increase from 0.2% to 1.7%) and 65 years and older and the absolute number of deaths in this group is moderate. 21,22 Several drug-drug interactions involving antimicrobial agents were also added to Table 5, and the recommendation to avoid concurrent use of three or more CNS-active medications was reformatted to clarify and bring further attention to the increased risk of falls and other harms that can occur when multiple CNS-active medications are combined. 23 PIM use continues to be a serious problem in older adults and especially in vulnerable older adults with multiple chronic conditions.…”

Section: Strength Of Recommendationmentioning

confidence: 99%

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American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

2019

J American Geriatrics Society

2,501

1,043

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The American Geriatrics Society (AGS) Beers Criteria® (AGS Beers Criteria®) for Potentially Inappropriate Medication (PIM) Use in Older Adults are widely used by clinicians, educators, researchers, healthcare administrators, and regulators. Since 2011, the AGS has been the steward of the criteria and has produced updates on a 3‐year cycle. The AGS Beers Criteria® is an explicit list of PIMs that are typically best avoided by older adults in most circumstances or under specific situations, such as in certain diseases or conditions. For the 2019 update, an interdisciplinary expert panel reviewed the evidence published since the last update (2015) to determine if new criteria should be added or if existing criteria should be removed or undergo changes to their recommendation, rationale, level of evidence, or strength of recommendation. J Am Geriatr Soc 67:674–694, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Strength Of Recommendationmentioning

confidence: 99%

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

2019

J American Geriatrics Society

2,501

1,043

View full text Add to dashboard Cite

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“…Patients with cancer experience a high prevalence of chronic pain after completing active treatment [10][11][12] and comorbid mental health conditions associated with an increased risk for opioid addiction and overdose. Despite having the lowest opioid overdose mortality rate of any age group, 23 adults who are 65 years old or older have experienced sharp increases in opioidrelated hospitalizations and emergency department visits 24 and opioid use disorder treatment admissions in recent years. Newonset persistent opioid use specifically is being increasingly recognized as a serious and common health care complication demanding concerted prevention strategies, including strategies for patients undergoing curative cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Older adults also have unique opioid-related risks and considerations. Despite having the lowest opioid overdose mortality rate of any age group, 23 adults who are 65 years old or older have experienced sharp increases in opioidrelated hospitalizations and emergency department visits 24 and opioid use disorder treatment admissions in recent years. 25 Older adults are physiologically more vulnerable to adverse effects of opioids than other age groups because of slower opioid metabolism and clearance, 26 and they more often obtain opioids for misuse from physician prescriptions than younger adults.…”

Section: Introductionmentioning

confidence: 99%

New‐onset persistent opioid use following breast cancer treatment in older adult women

Roberts

Fergestrom

Neuner

et al. 2019

Cancer

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BACKGROUND: Patients with cancer-related pain are underrepresented in the opioid literature despite high opioid exposure and numerous risk factors for adverse opioid outcomes, including unnecessary persistent opioid use. The objective of this study was to determine the extent, historical trends, and predictors of new-onset persistent opioid use among older adult women after active breast cancer treatment. METHODS: Using Surveillance, Epidemiology, and End Results-Medicare data for opioid-naive women diagnosed with stage 0 to III breast cancer at the age of 66 to 90 years between 2008 and 2013, this study estimated overall and quarterly adjusted probabilities of new-onset persistent opioid use, which was defined as receiving ≥90 days' supply of opioids in the year after active breast cancer treatment. Sensitivity analyses were conducted with an alternative definition of persistent opioid use: any opioid fill 90 to 180 days after active cancer treatment. RESULTS: Nearly two-thirds of the subjects received prescription opioid therapy during cancer treatment. Quarterly probabilities of new-onset persistent opioid use after active treatment ranged from 2% to 4%; in sensitivity analyses, the alternative outcome definition resulted in predicted probabilities ranging from 11.4% to 14.7%. Subjects with more advanced disease, a higher comorbidity burden, a low-income status, and greater opioid exposure during active cancer treatment were more likely to develop persistent opioid use. CONCLUSIONS: Persistent opioid use was an infrequent occurrence among older adult patients with breast cancer completing cancer treatment between 2008 and 2013. This finding was encouraging because of the concerning opioid trends seen in noncancer populations. However, opportunities to further mitigate unsafe opioid use as a complication of cancer care, including standardization of persistent opioid use definitions, should be explored. Cancer 2020;126:814-822.

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“…The misuse of opioids has led to dramatic increases in opioid-related mortality with opioid-related deaths increasing by 345% from 2001 to 2016 in the USA. 1,2 The marketing of opioids by the pharmaceutical industry to providers is well documented, with 1 in 12 US physicians receiving opioid-related industry payments. 3 However, it is unclear how or even if pharmaceutical industry payments are related to opioid-related deaths, or if disparities exist in marketing efforts for at-risk populations.…”

Section: Introductionmentioning

confidence: 99%