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What are characteristics that increase the chance a patient is at risk for opioid-related death? A recent JAMA article begins to tackle this very issues. Baumblatt et al. found the following:
1) Patient with 4 or more prescribers had adjusted odds ratio 6.5 for opioid-related death
2) Patient with 4 or more pharmacies where they get their prescriptions aOR - 6.0
3) Patient with more than 100 mg of morphine equivalents mean per day aOR - 11.2
With the new Maryland Prescription Drug Monitoring program (PDMP) we can start looking at a patient's prescription drug use pattern. The recent JAMA article can help you identify patients at high risk to die an opioid-related death. Use the PDMP and be wary if a patient has more than 4 prescribers or pharmacies or has >100mg of morphine equivalents per day.
References
High-Risk Use by Patients Prescribed Opioids for Pain and Its Role in Overdose Deaths.
Baumblatt JA, Wiedeman C, Dunn JR, Schaffner W, Paulozzi LJ, Jones TF.
JAMA Intern Med. 2014 Mar 3. doi: 10.1001/jamainternmed.2013.12711. [