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. 2023 Sep 1;18(1):53.
doi: 10.1186/s13011-023-00561-y.

Drugs involved in Kentucky drug poisoning deaths and relation with antecedent controlled substance prescription dispensing

Patricia R Freeman  1 , Jana McAninch  2 , Nabarun Dasgupta  3 , Douglas R Oyler  4 , Krassimir Slavov  5 , Candice Collins  2 , Sarah Hargrove  6 , Edward Freeman  7 , Dustin Miracle  4 , Svetla Slavova  5   6
Affiliations

Drugs involved in Kentucky drug poisoning deaths and relation with antecedent controlled substance prescription dispensing

Patricia R Freeman et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: The shift from prescription to illicit drugs involved in drug poisoning deaths raises questions about the current utility of prescription drug monitoring program (PDMP) data to inform drug poisoning (overdose) prevention efforts. In this study, we describe relations between specific drugs involved in Kentucky drug poisoning deaths and antecedent controlled substance (CS) dispensing.

Methods: The study used linked death certificates and PDMP data for 2,248 Kentucky resident drug poisoning deaths in 2021. Death certificate literal text analysis identified drugs mentioned with involvement (DMI) in drug poisoning deaths. We characterized the concordance between each DMI and the CS dispensing history for this drug at varying timepoints since 2008.

Results: Overall, 25.5% of all decedents had dispensed CS in the month before fatal drug poisoning. Over 80% of decedents were dispensed opioid(s) since 2008; the percentage was similar regardless of opioid involvement in the poisoning death. One-third of decedents had dispensed buprenorphine for treatment of opioid use disorder since 2008, but only 6.1% had dispensed buprenorphine in the month preceding death. Fentanyl/fentanyl analogs were DMI in 1,568 (69.8%) deaths, yet only 3% had received a fentanyl prescription since 2008. The highest concordance in the month preceding death was observed for clonazepam (43.6%).

Conclusion: Overall, concordance between CS dispensing history and the drugs involved in poisoning deaths was low, suggesting a need to reevaluate the complex relationships between prescription medication exposure and overdose death and to expand harm reduction interventions both within and outside the healthcare system to reduce drug poisoning mortality.

Keywords: Drug poisoning; Opioid; Overdose death; Prescription monitoring program; Stimulant.

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Conflict of interest statement

ND is on the Scientific Advisory Board for the non-profit RADARS System of Denver Health and Hospitals Authority, Denver, Colorado.

Figures

Fig. 1
Fig. 1
Median time (years/days from the last dispensed prescription for specific medications to drug poisoning deaths, Kentucky drug poisoning decedents, 2021 * Methadone for treatment of opioid use disorder is not reported to the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system. Gabapentin became a Schedule V controlled substance in Kentucky, reportable to KASPER on July 1, 2017 Note: The reported number of decedents with history of specific dispensed controlled substance includes everyone with such history, regardless of the involvement of the substance in the drug poisoning death
See this image and copyright information in PMC

References

    1. Bohnert AS, Valenstein M, Bair MJ et al. Association between opioid prescribing patterns and opioid overdose-related deaths. Jama. Apr 6 2011;305(13):1315-21. 10.1001/jama.2011.370. - PubMed
    1. Dasgupta N, Funk MJ, Proescholdbell S, Hirsch A, Ribisl KM, Marshall S. Cohort study of the impact of high-dose opioid analgesics on overdose mortality. Pain Med. 2016;17(1):85–98. doi: 10.1111/pme.12907. - DOI - PubMed
    1. Dunn KM, Saunders KW, Rutter CM, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Annals of Internal Medicine Jan. 2010;19(2):85–92. doi: 10.7326/0003-4819-152-2-201001190-00006. - DOI - PMC - PubMed
    1. Hartung DM, Johnston KA, Hallvik S, et al. Prescription opioid dispensing patterns prior to Heroin Overdose in a state Medicaid Program: a case-control study. J Gen Intern Med Nov. 2020;35(11):3188–96. doi: 10.1007/s11606-020-06192-4. - DOI - PMC - PubMed
    1. Paulozzi LJ, Kilbourne EM, Shah NG, et al. A history of being prescribed controlled substances and risk of drug overdose death. Pain Med (Malden Mass) Jan. 2012;13(1):87–95. doi: 10.1111/j.1526-4637.2011.01260.x. - DOI - PubMed

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