Marc R. Larochelle, M.D., M.P.H., from the Boston University School of Medicine and Boston Medical Center, and colleagues used eight individually linked data sets from state government agencies to retrospectively identify past 12-month exposure to four opioid prescription touchpoints (high dosage, benzodiazepine coprescribing, multiple prescribers, or multiple pharmacies) and four critical encounter touchpoints (opioid detoxification, nonfatal opioid overdose, injection-related infection, and release from incarceration) among Massachusetts residents ≥11 years of age in 2014.
During 6,717,390 person-years of follow-up, there were 1,315 opioid overdose deaths. The researchers found that in 2.7 percent of person-months and for 51.8 percent of opioid overdose deaths, there was past 12-month exposure to any touchpoints. Opioid overdose standardized mortality ratios were 12.6 for opioid prescription and 68.4 for critical encounter touchpoints. Fatal opioid overdose population attributable fractions were 0.19 and 0.37 for opioid prescription and critical encounter touchpoints, respectively.
“These data show that while opioid prescribing stewardship is an important goal, there are additional missed opportunities to provide harm reduction services and treatment for individuals at high-risk of opioid overdose death,” Larochelle said in a statement.
Larochelle disclosed a research grant from Optum Labs.