CoChat
Sign Up
Cited by 1,509Opioid Use Disorder TreatmentPain Management and Opioid UsePharmaceutical Practices and Patient Outcomes

The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.

Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths

Bohnert, Amy S. B.·2011·JAMA
DOI 10.1001/jama.2011.370
Open this paper in CoChat — free account

Abstract

CONTEXT: The rate of prescription opioid-related overdose death increased substantially in the United States over the past decade. Patterns of opioid prescribing may be related to risk of overdose mortality. OBJECTIVE: To examine the association of maximum prescribed daily opioid dose and dosing schedule ("as needed," regularly scheduled, or both) with risk of opioid overdose death among patients with cancer, chronic pain, acute pain, and substance use disorders. DESIGN: Case-cohort study. SETTING: Veterans Health Administration (VHA), 2004 through 2008. PARTICIPANTS: All unintentional prescription opioid overdose decedents (n = 750) and a random sample of patients (n = 154,684) among those individuals who used medical services in 2004 or 2005 and received opioid therapy for pain. Main Outcome Measure Associations of opioid regimens (dose and schedule) with death by unintentional prescription opioid overdose in subgroups defined by clinical diagnoses, adjusting for age group, sex, race, ethnicity, and comorbid conditions. RESULTS: The frequency of fatal overdose over the study period among individuals treated with opioids was estimated to be 0.04%.The risk of overdose death was directly related to the maximum prescribed daily dose of opioid medication. The adjusted hazard ratios (HRs) associated with a maximum prescribed dose of 100 mg/d or more, compared with the dose category 1 mg/d to less than 20 mg/d, were as follows: among those with substance use disorders, adjusted HR = 4.54 (95% confidence interval [CI], 2.46-8.37; absolute risk difference approximation [ARDA] = 0.14%); among those with chronic pain, adjusted HR = 7.18 (95% CI, 4.85-10.65; ARDA = 0.25%); among those with acute pain, adjusted HR = 6.64 (95% CI, 3.31-13.31; ARDA = 0.23%); and among those with cancer, adjusted HR = 11.99 (95% CI, 4.42-32.56; ARDA = 0.45%). Receiving both as-needed and regularly scheduled doses was not associated with overdose risk after adjustment. CONCLUSION: Among patients receiving opioid prescriptions for pain, higher opioid doses were associated with increased risk of opioid overdose death.

Overview

Integrity signals

Registry

Crossref · 10.1001/jama.2011.370

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

Cited by

Sorted by citations

See all 1,509

Related

See all

Metadata

Authors
Bohnert, A. S. B.
Affiliations
University of Michigan (US)
Corresponding author
Bohnert, Amy S. B.
ORCID
Bohnert, Amy S. B.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2011-04-06
Volume
305
Issue
13
Pages
1315
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2011.370
OpenAlex
W2070123858
Cited by
1,509
References
26
Citations by year
2026: 24 · 2025: 46 · 2024: 82 · 2023: 67 · 2022: 94 · 2021: 150 · 2020: 141 · 2019: 170 · 2018: 139 · 2017: 138 · 2016: 109 · 2015: 100 · 2014: 84 · 2013: 69 · 2012: 65
FWCI
77.70
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
prescription opioid overdose, opioid prescribing patterns, as-needed dosing, opioid overdose deaths, cancer pain, chronic pain, acute pain, substance use disorders, veterans, opioid analgesics, overdose risk factors, Veterans Health Administration, veterans' health care utilization
MeSH terms
Acute Disease, Adolescent, Adult, Aged, Analgesics, Opioid, Chronic Disease, Female, Humans, Male, Middle Aged, Pain, Practice Patterns, Physicians', Drug Prescriptions, Risk, United States, Veterans, Cohort Studies, Case-Control Studies, Young Adult, Drug Overdose

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review