Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis

Details

• Alternative Title:
  Inj Epidemiol
• Personal Author:
  Brady, Joanne E. ; Giglio, Rebecca ; Keyes, Katherine M. ; DiMaggio, Charles ; Li, Guohua
• Description:
  Background
  
  Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature. Eligible cohort, case-control, cross-sectional, and case-cohort studies were reviewed and data were extracted for qualitative and quantitative synthesis.
  
  Findings
  
  Summary odds ratios (SOR) were estimated from 29 studies for six risk markers: sex, age, race, psychiatric disorders, substance use disorder (SUD), and urban/rural residence. Heterogeneity was assessed and effect estimates were stratified by study characteristics. Of the six risk markers identified, SUD had the strongest association with drug overdose death (SOR = 5.24, 95% confidence interval (CI) = 3.53 - 7.76), followed by psychiatric disorders (SOR = 3.94, 95% CI = 3.09 - 5.01), white race (SOR = 2.28, 95% CI = 1.93 - 2.70), the 35-44 year age group relative to the 25-34 year reference group (SOR = 1.52, 95% CI = 1.31 - 1.76), and male sex (SOR = 1.33, 95% CI = 1.17 - 1.51).
  
  Conclusions
  
  This review highlights fatal and non-fatal prescription drug risk markers most frequently assessed in peer-reviewed and grey literature. There is a need to better understand modifiable risk markers and underlying reasons for drug misuse in order to inform interventions that may prevent future drug overdoses.
  
  
• Subjects:
  Accidents Analgesics Drug Overdose Mortality Opioid/toxicity Prescription Drugs/toxicity Prevalence Public Health Review Risk Factors Substance-related Disorder

  More +
• Source:
  Inj Epidemiol. 4.
• Pubmed ID:
  28762157
• Pubmed Central ID:
  PMC5545182
• Document Type:
  Journal Article
• Funding:
  K01 AA021511/AA/NIAAA NIH HHS/United States ; R01 HD087460/HD/NICHD NIH HHS/United States ; R49 CE002096/CE/NCIPC CDC HHS/United States
• Volume:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5fae37bce686cad8562e9ef1e3bad6bb52aebc43820a2e69bfa0f0e6c3cfe8b5
• Download URL:
  https://stacks.cdc.gov/view/cdc/49130/cdc_49130_DS1.pdf
• File Type:
  [PDF - 1.37 MB ]