Study author Deborah Fulton-Kehoe, PhD, told Clinical Pain Advisor that opioid prescribing guidelines need to be reviewed and amended to address opioid poisoning in acute and intermittent users on low prescribed doses, too. 

“Guidelines must do more than limit the dose and duration of opioid therapy since these risk factors are not present in many opioid overdoses,” she said. “There needs to be a renewed focus on non-opioid therapies for chronic pain.”

Another contributing factor was concurrent use of sedatives. The study’s findings noted that nearly 50% of patients also had a sedative prescription at the time of their opioid overdose.

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According to co-author, Mark Sullivan, MD, a physician at the University of Washington: “Most patients with severe chronic pain also have insomnia and anxiety; hence, prescribing of sedative-hypnotics (including benzodiazepines) and muscle relaxants is common. These drugs add to the respiratory depressant effects of opioids in an unpredictable and dangerous manner.”