Opioid overdose odds soar after a family member fills a prescription

  • Khan NF & al.
  • JAMA Intern Med

  • International Clinical Digest
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Takeaway

  • Access to a family member’s opioids is associated with higher odds of an opioid overdose.
  • Authors suggest educating patients about the risks family members face.

Why this matters

  • 2 recent studies found that most people misusing opioids get their supply from people in their family.
  • Most postsurgical patients report having leftover opioid pills.

Key results

  • Prior dispensing to a family member was associated with higher odds of overdose: OR, 2.89; 95% CI, 2.59-3.23.
  • Higher number of morphine milligram equivalents (MME) dispensed to family member(s) correlated with higher ORs (95% CIs):
    • ≤50 MME/day: 2.71 (2.42-3.03).
    • 50-89 MME/day: 7.80 (3.63-16.78). 
    • ≥90 MME/day: 15.08 (8.66-26.27).
  • Higher odds and a dose-response effect were also found in children.
  • Odds rose with more recent exposure.

Study design

  • Case-control study of national commercial claims data, 2004-2015. 
  • Authors matched 2303 people affected by overdose to 9212 controls and examined associations with family members’ opioid prescriptions.
  • Outcome: odds of opioid overdose resulting in emergency department (ED) visit or hospitalization vs in patients without family member to whom opioids were dispensed.
  • Funding: Brigham and Women’s Hospital.

Limitations

  • Outcome comprised both prescription and street opioids and did not capture overdoses not presenting to ED.