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Cohort study
Cohort study finds nine times increased overdose risk (fatal plus non-fatal) in patients receiving 100 mg/day for 90 days compared with 1–20 mg/day opioids for chronic non-cancer pain, but wide CI and possibility of unmeasured confounders
  1. Joel Simon Hochman1,
  2. Joe Pergolizzi2,3
  1. 1 National Foundation for the Treatment of Pain, Houston, Texas, USA
  2. 2 Department of Anesthesiology, Georgetown University School of Medicine, Washington, District of Columbia, USA
  3. 3 Naples Anesthesia and Pain Associates, Naples, Florida, USA
  1. Correspondence to Joel Simon Hochman
    Executive Director, National Foundation for the Treatment of Pain, 1714 White Oak Drive, Houston, TX 770099, USA; jfshmd{at}gmail.com

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Dunn and colleagues are employed at Group Health Research Institute, the Arthritis Research Campaign National Primary Care Centre and Kaiser Permanent, with affiliations at the University of Washington and the University of California in San Francisco, and with funding from the National Institute of Drug Abuse. From their website (http://www.grouphealthresearch.org/aboutus/aboutghri.html) we note that “Group Health Research Institute (GHRI) is a non-proprietary, public-domain research institution within Group Health, a health care system based in Seattle, Washington. Group Health Cooperative is a consumer-governed, nonprofit health care system that coordinates care and coverage. Based in Seattle, Group Health and its subsidiary health carriers, Group Health Options, Inc. and KPS Health Plans, serve nearly 600,000 residents of Washington State and Idaho. More than 70% of members receive care in Group Health-owned medical facilities.”

This study addressed the increasing frequency of long-term opioid treatment for chronic pain and the doubling of hospitalisations for overdose in Washington, DC. The authors noted a study in West Virginia which found that fewer than 44% of people who died of unintentional prescription drug overdose had received opioids from a physician, which suggests that …

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