| アブストラクト | BACKGROUND AND AIMS: An apparently protective effect of opioid agonist treatment (OAT) on all-cause and cause-specific mortality risk has been widely reported. Non-fatal overdose (NFO) often precedes subsequent drug-poisoning deaths. We hypothesized that benzodiazepines, gabapentinoids, antipsychotics, antidepressants, Z-drugs or opioids increase the NFO risk when co-prescribed with OAT. DESIGN: We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases. The cohort was linked to Hospital Episode Statistics admitted patient care data (HES-APC), neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records from the Office for National Statistics. SETTING: Primary care in England. PARTICIPANTS: We studied patients with opioid use disorder, aged 18-64 years, who were prescribed OAT (15155 methadone and 5743 buprenorphine recipients) between Jan 1, 1998, and Dec 31, 2017. MEASUREMENTS: The main outcome examined was NFO risk during co-prescription of OAT with benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z-drugs or opioids. Overdose was defined according to International Classification of Diseases codes from the HES-APC data set. Negative binomial regression models were used to estimate weighted rate ratios (wRR) for NFO during co-prescription of OAT and benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z-drugs or opioids with periods of exclusive OAT usage. FINDINGS: Among 20 898 patients observed over 83 856 person-years, we found an elevated overdose risk that resulted in hospital admission during co-prescription of OAT with benzodiazepines [wRR: 1.45; 95% confidence interval (CI) = 1.26-1.67], gabapentinoids (wRR = 2.22; 95% CI = 1.77-2.79), Z-drugs (wRR = 1.60; 95% CI = 1.31-1.96), antipsychotics (wRR = 1.85; 95% CI = 1.53-2.25) and opioids (wRR = 1.28; 95% CI = 1.02-1.60). The risk ratio for antidepressant co-prescriptions was below unity (wRR = 0.90; 95% CI = 0.79-1.02) but this result was not statistically significant. CONCLUSION: Elevated risk of non-fatal overdose among opioid agonist treatment recipients is associated with concurrent use of medication prescribed for other reasons. |
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| ジャーナル名 | Addiction (Abingdon, England) |
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| 投稿日 | 2023/8/4 |
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| 投稿者 | Domzaridou, Eleni; Carr, Matthew J; Millar, Tim; Webb, Roger T; Ashcroft, Darren M |
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| 組織名 | National Institute for Health and Care Research Greater Manchester Patient Safety;Translational Research Centre, Manchester Academic Health Science Centre,;University of Manchester, Manchester, UK.;Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health,;Centre for Mental Health and Safety, Division of Psychology and Mental Health,;School of Health Sciences, Faculty of Biology, Medicine and Health, University of;Manchester, Manchester, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37536685/ |
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