Understanding opioid overdose characteristics involving prescription and illicit opioids: A mixed methods analysis

Bobbi Jo H Yarborough, Scott P. Stumbo, Shannon L. Janoff, Micah T. Yarborough, Dennis McCarty, Howard D. Chilcoat, Paul M. Coplan, Carla A. Green

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Opioid abuse and misuse are significant public health issues. The CDC estimated 72% of pharmaceutical-related overdose deaths in the US in 2012 involved opioids. While studies of opioid overdoses have identified sociodemographic characteristics, agents used, administration routes, and medication sources associated with overdoses, we know less about the context and life circumstances of the people who experience these events. Methods: We analyzed interviews (n = 87) with survivors of opioid overdoses or family members of decedents. Individuals experiencing overdoses were members of a large integrated health system. Using ICD codes for opioid overdoses and poisonings, we identified participants from five purposefully derived pools of health-plan members who had: 1) prescriptions for OxyContin. ® or single-ingredient sustained-release oxycodone, 2) oxycodone single-ingredient immediate release, 3) other long-acting opioids, 4) other short-acting opioids, or 5) no active opioid prescriptions. Results: Individuals who experienced opioid overdoses abused and misused multiple medications/drugs; experienced dose-related miscommunications or medication-taking errors; had mental health and/or substance use conditions; reported chronic pain; or had unstable resources or family/social support. Many had combinations of these risks. Most events involved polysubstance use, often including benzodiazepines. Accidental overdoses were commonly the result of abuse or misuse, some in response to inadequately treated chronic pain or, less commonly, medication-related mistakes. Suicide attempts were frequently triggered by consecutive negative life events. Conclusions: To identify people at greater risk of opioid overdose, efforts should focus on screening for prescribed and illicit polysubstance use, impaired cognition, and changes in life circumstances, psychosocial risks/supports, and pain control.

Original languageEnglish (US)
JournalDrug and Alcohol Dependence
DOIs
StateAccepted/In press - Nov 23 2015

Fingerprint

Opioid Analgesics
Prescriptions
Oxycodone
Health
Chronic Pain
Medication Errors
International Classification of Diseases
Public health
Centers for Disease Control and Prevention (U.S.)
Benzodiazepines
Social Support
Pharmaceutical Preparations
Poisoning
Suicide
Cognition
Survivors
Mental Health
Screening
Public Health
Interviews

Keywords

  • Intervention
  • Opioid analgesics
  • Overdose
  • Prevention
  • Risk

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Understanding opioid overdose characteristics involving prescription and illicit opioids : A mixed methods analysis. / Yarborough, Bobbi Jo H; Stumbo, Scott P.; Janoff, Shannon L.; Yarborough, Micah T.; McCarty, Dennis; Chilcoat, Howard D.; Coplan, Paul M.; Green, Carla A.

In: Drug and Alcohol Dependence, 23.11.2015.

Research output: Contribution to journalArticle

Yarborough, Bobbi Jo H ; Stumbo, Scott P. ; Janoff, Shannon L. ; Yarborough, Micah T. ; McCarty, Dennis ; Chilcoat, Howard D. ; Coplan, Paul M. ; Green, Carla A. / Understanding opioid overdose characteristics involving prescription and illicit opioids : A mixed methods analysis. In: Drug and Alcohol Dependence. 2015.
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