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Opioids sometimes are appropriate for patients with chronic pain, but overdose is becoming more common. Because risk for overdose has not been well described among patients for whom opioids are prescribed, investigators studied 9940 patients with pain (mostly back or limb pain) and at least three prescriptions of opioid analgesics within 90 days in a Washington State health cooperative. Patients with cancer were excluded.
During a mean 42-month follow-up, 51 patients experienced serious intentional or unintentional overdoses; 6 overdoses were fatal, and 45 were nonfatal (13 definitely opioid related and 32 probably opioid related, based on medical record review). Recent opioid prescription was associated with serious overdose (hazard ratio, …