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. 2019 Dec;23(12):3331-3339.
doi: 10.1007/s10461-019-02589-3.

Prescription of High-Dose Opioids Among People Living with HIV in British Columbia, Canada

Jessica Clark  1 , Nadia Fairbairn  1   2 , Seonaid Nolan  1   2 , Tian Li  3 , Anthony Wu  3 , Rolando Barrios  3   4 , Julio Montaner  1   3 , Lianping Ti  5   6   7 ; STOP HIV/AIDS in BC Study Group
Collaborators, Affiliations

Prescription of High-Dose Opioids Among People Living with HIV in British Columbia, Canada

Jessica Clark et al. AIDS Behav. 2019 Dec.

Abstract

People living with HIV (PLHIV) often experience pain for which opioid medications may be prescribed. Thus, these individuals are particularly vulnerable to opioid-related harms, including overdose, misuse, and addiction, particularly when prescribed at high doses. We used a comprehensive linked population-level database of PLHIV in British Columbia (BC) to identify demographic and clinical characteristics associated with being prescribed any high-dose opioid analgesic, defined as > 90 daily morphine milligram equivalents (MME/day). Among PLHIV who were prescribed opioids between 1996 and 2015 (n = 10,780), 28.2% received prescriptions of > 90 MME/day at least once during the study period. Factors positively associated with being prescribed high-dose opioid analgesics included: co-prescription of benzodiazepines (adjusted odds ratio [AOR] = 1.14; 95% confidence interval 1.11-1.17); presence of an AIDS-defining illness (ADI; AOR = 1.78; 95% CI 1.57-2.02); seen by an HIV specialist (AOR = 1.24; 95% CI 1.20-1.29); substance use disorder (AOR = 1.46; 95% CI 1.25-1.71); and more recent calendar year (AOR = 1.05; 95% CI 1.04-1.06). Given the known risks associated with high-dose opioid prescribing, future research efforts should focus on the clinical indication and outcomes associated with these prescribing practices.

Keywords: Analgesics; Pain; People living with HIV; Prescription opioids.

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References

    1. Hewitt DJ, McDonald M, Portenoy RK, Rosenfeld B, Passik S, Breitbart W. Pain syndromes and etiologies in ambulatory AIDS patients. Pain. 1997;70(2):117–23. - PubMed
    1. Penfold J, Clark AJM. Pain syndromes in HIV infection. Can J Anaesth. 1992;39(7):724–30. - PubMed
    1. Parker R, Stein DJ, Jelsma J. Pain in people living with HIV/AIDS: a systematic review. J Int AIDS Soc. 2014;17(1):18719. - PMC - PubMed
    1. Merlin JS, Cen L, Praestgaard A, et al. Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J Pain Symptom Manag. 2012;43(3):638– - PMC - PubMed
    1. Aouizerat BE, Miaskowski CA, Gay C, et al. Risk factors and symptoms associated with pain in HIV-infected adults. J Assoc Nurses AIDS Care. 2010;21(2):125–33. - PMC - PubMed