In adults with chronic pain on high dose opioids, does coprescription with naloxone reduce morbidity and mortality from opioid overdose compared to no naloxone coprescription?

摘要

Opioid management of chronic pain in clinical settings is becoming more common with physicians now prescribing substantially more opioids than twenty years ago. However, with increasing prescription comes greater frequency of misuse and overdose of prescription opioid medications. Per the CDC, unintentional injury deaths are the most common cause of death in adults aged 25 to 64, with unintentional poisonings being the most common unintentional injury. Over half of unintentional poisonings are due to opioid overdose, causing twenty eight thousand deaths in 2014 alone.1 Because of this issue, primary and secondary interventions are being sought out to help prevent and/or treat opioid intoxication in order to preserve life in a safe and cost effective manner. One specific area of interest is in providing naloxone prescription and medication training to patients on opioid therapy as a means of combating overdose in the moment. This review reveals that such programs, which are being done throughout the United States, are feasible as well as helpful in reducing overall morbidity and mortality in the event of overdose with very little risk. We conclude that continued implementation of such programs would be of benefit to patients prescribed high dose opioid therapy.