{"id":4191,"date":"2015-08-20T00:00:00","date_gmt":"2015-08-20T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\/"},"modified":"2023-06-14T19:46:15","modified_gmt":"2023-06-14T23:46:15","slug":"sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\/","title":{"rendered":"Sex differences in dose escalation and overdose death during chronic opioid therapy: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown.<\/p>\n<p><span class=\"bold\">Methods and Findings<\/span> &#x2014; We conducted a cohort study using healthcare records of 32,499 individuals aged 15 to 64 who commenced chronic opioid therapy for noncancer pain between April 1, 1997 and December 31, 2010 in Ontario, Canada. Patients were followed from their first opioid prescription until discontinuation of therapy, death from any cause or the end of the study period. Among patients receiving chronic opioid therapy, 589 (1.8%) escalated to high dose therapy and n=59 (0.2%) died of opioid-related causes while on treatment. After multivariable adjustment, men were more likely than women to escalate to high-dose opioid therapy (adjusted hazard ratio 1.44; 95% confidence interval 1.21 to 1.70) and twice as likely to die of opioid-related causes (adjusted hazard ratio 2.04; 95% confidence interval 1.18 to 3.53). These associations were maintained in a secondary analysis of 285,520 individuals receiving any opioid regardless of the duration of therapy.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Men are at higher risk than women for escalation to high-dose opioid therapy and death from opioid-related causes. Both outcomes were more common than anticipated.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown. Methods and Findings &#x2014; [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[56],"migration-helper-qa-sample-set":[],"class_list":["post-4191","journal_article","type-journal_article","status-publish","hentry","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Kaplovitch E, Gomes T, Camacho X, Dhalla IA, Mamdani MM, Juurlink D. <em>PLoS One<\/em>. 2015; 10(8):e0134550. Epub 2015 Aug 20.","source_url":"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0134550","ices_scientist":[1282,1252,1325,1213],"site":[6733,6735],"research_program":[6746],"news_release":[7813],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"EC87E9F6-4FC9-4495-8646-809F6FD09408","sitecore_item_name":"Sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy","sitecore_field_values":"{\n  \"__Valid from\": \"20170728T105638\",\n  \"Title\": \"Sex differences in dose escalation and overdose death during chronic opioid therapy: a population-based cohort study\",\n  \"Short title\": \"Sex differences in dose escalation\",\n  \"Summary\": \"Among people receiving chronic opioid therapy, men are more likely than women both to escalate to high doses and to die from opioid-related causes.\",\n  \"Citation\": \"<p>Kaplovitch E, Gomes T, Camacho X, Dhalla IA, Mamdani MM, Juurlink D. <em>PLoS One<\/em>. 2015; 10(8):e0134550. Epub 2015 Aug 20.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown.<\/p>n<p><span class=\"bold\">Methods and Findings<\/span> &mdash; We conducted a cohort study using healthcare records of 32,499 individuals aged 15 to 64 who commenced chronic opioid therapy for noncancer pain between April 1, 1997 and December 31, 2010 in Ontario, Canada. Patients were followed from their first opioid prescription until discontinuation of therapy, death from any cause or the end of the study period. Among patients receiving chronic opioid therapy, 589 (1.8%) escalated to high dose therapy and n=59 (0.2%) died of opioid-related causes while on treatment. After multivariable adjustment, men were more likely than women to escalate to high-dose opioid therapy (adjusted hazard ratio 1.44; 95% confidence interval 1.21 to 1.70) and twice as likely to die of opioid-related causes (adjusted hazard ratio 2.04; 95% confidence interval 1.18 to 3.53). These associations were maintained in a secondary analysis of 285,520 individuals receiving any opioid regardless of the duration of therapy.<\/p>n<p><strong>Conclusions<\/strong> &mdash; Men are at higher risk than women for escalation to high-dose opioid therapy and death from opioid-related causes. Both outcomes were more common than anticipated.<\/p>n<p><a href=\"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0134550\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{84FE2CDF-5B86-4CD1-A954-9886D022974F}|{B711DE54-5056-420D-AA0E-1349F1D88049}|{3B67F4BE-E30A-434A-8669-AE2A085C94E0}\",\n  \"Related Products\": \"<h2>NEWS RELEASE<\/h2>rn<h3><a href=\"~\/link.aspx?_id=C2EA17A23568458CA560A09A5E84A267&amp;_z=z\">New study establishes risk of death during chronic opioid therapy, showing men at much higher risk than women <\/a><\/h3>rn<h2>ICES IN THE NEWS<\/h2>rn<h3><a href=\"http:\/\/www.theglobeandmail.com\/life\/health-and-fitness\/health\/staggering-number-of-chronic-opioid-patients-dying-according-to-new-study\/article26036969\/\" title=\"Opens in new window\" target=\"_blank\">&lsquo;Staggering&rsquo; number of chronic opioid patients dying, according to new study<\/a><\/h3>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}|{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}\",\n  \"ICES Scientists\": \"{5268F1B0-EB3E-4577-93DF-3C70C9399847}|{1FA4634A-81DF-4A25-8739-98ABF3872B45}|{F2F916BC-2EE9-4C65-BCAB-086ED6BB971A}|{C3A1DE68-838D-4F81-AA49-35368583A9A8}\",\n  \"Posted Date\": \"20150820T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2015\/January\/Sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Sex differences in dose escalation and overdose death during chronic opioid therapy: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Sex differences in dose escalation and overdose death during chronic opioid therapy: a population-based cohort study\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:46:15+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/sex-differences-in-dose-escalation-and-overdose-death-during-chronic-opioid-therapy-a-population-based-cohort-study\\\/\",\"name\":\"ICES | Sex differences in dose escalation and overdose death during chronic opioid therapy: a population-based cohort study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2015-08-20T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:46:15+00:00\",\"description\":\"Background &#x2014; 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