Alcohol and Drug Overdose and the Influence of Pain Conditions in an Addiction Treatment Sample

Details

• Alternative Title:
  J Addict Med
• Personal Author:
  Fernandez, Anne C. ; Bush, Christopher ; Bonar, Erin E. ; Blow, Frederic C. ; Walton, Maureen A. ; Bohnert, Amy A.S.B.
• Description:
  Purpose:
  
  Overdose from alcohol and/or drugs kills tens of thousands of Americans annually, with a large number of deaths attributed to opioid pain medications. Addiction treatment patients are known to be at high risk for overdose; however, the relationship between pain and overdose history within this group is understudied, especially in relation to alcohol overdoses. In the present study we evaluated whether non-fatal overdose history was more likely among addiction treatment patients with pain, and examined the characteristics of overdoses among those with and without pain.
  
  Methods:
  
  We analyzed cross-sectional data from 739 patients at a large residential addiction treatment center (Median age = 37, 25.7% female). We used two stepped binary regression models to evaluate whether demographics, pain type (chronic, acute, or both), depression symptoms, and opioid misuse were associated with lifetime history of non-fatal (1) alcohol and (2) drug overdose (lifetime yes/no) and conducted follow-up analyses examining overdose characteristics.
  
  Results:
  
  In adjusted analyses, history of chronic pain (OR = 2.60; 95% CI [1.59, 4.27]) and illicit drug use (OR = 1.99; 95% CI [1.07, 3.68]) were associated with an increased likelihood of non-fatal alcohol overdose. Opioid misuse (OR = 3.11; 95% CI [2.51, 3.86]), depression symptoms (OR = 1.33; 95% CI [1.14, 1.55]), and younger age (OR = 0.96; 95% CI [0.94, 0.97]) were associated with increased likelihood of drug overdose. Those with pain reported a higher number of lifetime alcohol overdoses and were more likely to combine numerous drugs with alcohol prior to overdose.
  
  Conclusions:
  
  Pain conditions may play an under-recognized role in the overdose epidemic, particularly alcohol-related overdose. Addiction treatment and overdose prevention interventions should incorporate appropriate assessment and treatment of pain including education about the risks of polysubstance use, particularly combining alcohol with sedatives and prescription pain relievers.
  
  
• Subjects:
  Acute Pain Adult Age Factors Alcoholism Alcohol Use Disorder Article Chronic Pain Comorbidity Cross-Sectional Studies Depression Drug Overdose Female Humans Male Middle Aged Opioid-Related Disorders Overdose Residential Treatment Substance Use Disorder

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• Source:
  J Addict Med. 13(1):61-68
• Pubmed ID:
  30161038
• Pubmed Central ID:
  PMC6533535
• Document Type:
  Journal Article
• Funding:
  K23 AA023869/AA/NIAAA NIH HHS/United States ; R34 DA035331/DA/NIDA NIH HHS/United States ; U01 CE002780/CE/NCIPC CDC HHS/United States
• Volume:
  13
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:77a8035f03d7d47c995d4c6bb11ec029cc79fe9fa6f72d531f15e443e0b055a2
• Download URL:
  https://stacks.cdc.gov/view/cdc/101062/cdc_101062_DS1.pdf
• File Type:
  [PDF - 425.56 KB ]