Opioid Doses and Increased Risk for Overdose
Authors: William C. Becker
Journal: Annals of Internal Medicine (2010)

Letters6 July 2010Opioid Doses and Increased Risk for OverdoseWilliam C. Becker, MD, David A. Fiellin, MD, and Robert D. Kerns, PhDWilliam C. Becker, MDFrom Yale University School of Medicine, New Haven, CT 06510, and Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516.Search for more papers by this author, David A. Fiellin, MDFrom Yale University School of Medicine, New Haven, CT 06510, and Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516.Search for more papers by this author, and Robert D. Kerns, PhDFrom Yale University School of Medicine, New Haven, CT 06510, and Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-1-201007060-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dunn and colleagues (1) present sobering data on opioid overdose, showing a direct correlation between daily morphine equivalents and overdose rates. As echoed in the accompanying editorial by McLellan and Turner (2), these data remind every clinician prescribing opioids to thoroughly review the indication, effectiveness, and safety with patients.One safe medication-taking practice that is often overlooked is asking patients receiving long-term opioid treatment to contact the office when they are feeling unwell. Providers and patients, especially elderly patients and those with multiple comorbid conditions, should understand that the effective opioid dose when feeling relatively well may ...References1. Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152:85-92. [PMID: 20083827] LinkGoogle Scholar2. McLellan AT, Turner BJ. Chronic noncancer pain management and opioid overdose: time to change prescribing practices [Editorial]. Ann Intern Med. 2010;152:123-4. [PMID: 20083830] LinkGoogle Scholar3. Mercadante S. Opioid rotation for cancer pain: rationale and clinical aspects. Cancer. 1999;86:1856-66. [PMID: 10547561] CrossrefMedlineGoogle Scholar4. Inturrisi CE. Clinical pharmacology of opioids for pain. Clin J Pain. 2002;18:S3-13. [PMID: 12479250] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: William C. Becker, MD; David A. Fiellin, MD; Robert D. Kerns, PhDAffiliations: From Yale University School of Medicine, New Haven, CT 06510, and Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpioid Prescriptions for Chronic Pain and Overdose Kate M. Dunn , Kathleen W. Saunders , Carolyn M. Rutter , Caleb J. Banta-Green , Joseph O. Merrill , Mark D. Sullivan , Constance M. Weisner , Michael J. Silverberg , Cynthia I. Campbell , Bruce M. Psaty , and Michael Von Korff Chronic Noncancer Pain Management and Opioid Overdose: Time to Change Prescribing Practices A. Thomas McLellan and Barbara J. Turner Opioid Doses and Increased Risk for Overdose Milap C. Nahata and Katy E. Trinkley Opioid Doses and Increased Risk for Overdose Michael Von Korff and Kate Dunn Metrics Cited byOpioid and Other Substance Misuse, Overdose Risk, and the Potential for Prevention Among a Sample of OEF/OIF Veterans in New York City 6 July 2010Volume 153, Issue 1Page: 59KeywordsAttentionBlood plasmaConflicts of interestElderlyEmotionsGlomerular filtration rateMetabolitesMorphineOpioidsSafety ePublished: 6 July 2010 Issue Published: 6 July 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...