Chronic Pain, Psychiatric Disorders Increase Opioid Death Risk

Many individuals who die from opioid overdose have previously been diagnosed with a chronic pain condition and commonly have received treatment for drug use and mental health disorders in the last year of their life, according to the results of a recent study.

For their study, the researchers identified 13,089 opioid-related decedents, aged 64 years and younger, in the Medicaid program, examining clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The patients were segmented into 2 groups: those with chronic, non-cancer pain in the last year before death, and those without.
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Overall, 61.5% of the decedents had received diagnoses of chronic non-cancer pain in the last year of life. Those with chronic pain were significantly more likely to have filled prescriptions for opioids (49% vs 17.2%) and benzodiazepines (52.1% vs 26.6%) during the last 30 days of life. Diagnoses of opioid use disorder were uncommon in both groups (4.2% vs 4.3%). Those in the chronic pain group were also significantly more likely to receive diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life.

“Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare,” the researchers concluded.

—Michael Potts

Reference:

Olfson M, Wall M, Wang S, et al. Service use preceding opioid-related fatality [published online November 2017]. AJP. https://doi.org/10.1176/appi.ajp.2017.17070808