Family members' scripts spike when opioids, benzodiazepines discontinued

  • JAMA Intern Med

  • International Clinical Digest
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Takeaway

  • After discontinuation of a high-volume opioid or benzodiazepine user’s prescription, the user’s family members were significantly more likely to receive a first-time opioid or benzodiazepine prescription than family members of low-volume users whose prescriptions were discontinued.

Why this matters

  • Family members may be diverting opioids and benzodiazepines to relatives whose prescriptions have been terminated by their clinician.

Study design

  • Study of 463,637 and 357,632 high-volume and 4.9 and 2.1 million low-volume opioid and benzodiazepine users, respectively, who discontinued therapy during 2007-2016.
  • Funding: NIH.

Key results

  • Significant high risk for first-time opioid/benzodiazepine prescriptions was observed in family members of high-volume vs low-volume opioid users:
    • ≤2 days of discontinuation: 0.2% vs 0.06% (relative risk [RR], 3.53; 95% CI, 2.45-4.60).
    • ≤14 days of discontinuation: 0.5% vs 0.4% (RR, 4.16; 95% CI, 2.91-5.40).
  • Significant high risk for first-time opioid/benzodiazepine prescriptions was observed in family members of high-volume vs low-volume benzodiazepine users:
    • ≤2 days of discontinuation: 0.2% vs 0.06% (RR, 4.46; 95% CI, 2.85-6.07).
    • ≤14 days of discontinuation: 0.5% vs 0.3% (RR, 4.23; 95% CI, 2.70-5.77).

Limitations

  • Data limited to privately insured patients.

Coauthored with Antara Ghosh, PhD