Death from Opioid Overdose Linked to Dosage

Lisa Cantkier

A new study addresses the serious risks that accompany opioid use, showing that a patient’s risk of death from an opioid overdose may be influenced by the prescribed dosage.

Opioids are powerful pain medicines that are derived from the opium poppy or are chemically similar. They lower your pain signal intensity. Examples are methadone, morphine, oxycodone and tramadol.

According to the Centers for Disease Control and Prevention, “in recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis.” Opioids significantly contribute to the loss of 44 lives each day in the U.S. to overdose of prescription painkillers.

According to the World Health Organization, “opioids have the potential to cause substance dependence that is characterized by a strong desire to take opioids, impaired control over opioid use, persistent opioid use despite harmful consequences, a higher priority given to opioid use than to other activities and obligations, increased tolerance and a physical withdrawal reaction when opioids are discontinued. Due to their pharmacological effects, opioids in high doses can cause respiratory depression and death.”

Published in the journal Medical Care, the study reports that lowering opioid medication prescription strength may benefit patients who are at a high risk of overdose. The researchers analyzed and compared two groups of veterans who were prescribed opioid medication for chronic pain—subjects who were part of the first group died of accidental opioid overdose and subjects in the second group did not. They found the average prescribed daily dose of opioids for the overdose group was more than double the average prescribed daily dose of opioids to those who did not overdose.

The researchers concluded the current maximum daily dose of 100 morphine-equivalent mg (MEM) should be reviewed and reconsidered. “Lowering the recommended dosage threshold below the 100 MEM used in many recent guidelines would affect proportionately few patients not at risk for overdose while potentially benefitting many of those at risk for overdose.”

“As the United States grapples with the rising toll of accidental overdoses due to opioids, our findings suggest that changing clinical practices to avoid escalating doses for patients with chronic pain could make a major difference in the number of patients who die,” said Amy Bohnert, Ph.D., one of the lead researchers.

For more information about this study, click here.


Last Reviewed 02/15/16

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Lisa Cantkier, CHN is a certified holistic nutritionist and a health and wellness editor.


    I beg to differ.I have no clue the dose or how old these patients were. I have been prescribed opiates since 1999. Been of an on with uses of subutex for hyperalgesia. It helps when your dose stops working, I have so much more to say but until a physician has the same issue they would be singing a different tune. I have tried everything and the only thing that gives me any quality of life are opiates. This whole issue is scaring me and if they take my meds away I am DONE.

  • Kelly

    I agree with Elizabeth. Those who abuse opiates & overdose due to recreational use are giving those of us that really need them to function with daily chronic pain a bad name. Most of us tried everything to avoid using opiates but without them most of us who need them wouldn’t be able to work or have any sort of life. So is the CDC & federal government ready to pay our salary & health insurance after they lower the max dose? I don’t know about other patients but I started low & eventually the dose has to be increased due to the body building up a tolerance. If your body isn’t used to the opiates, & you start too high, then of coarse you can overdose. The patients with chronic pain shouldn’t be blamed, feel guilty for using them, or be penalized because of those that abuse it. If we take it responsibly & genuinely have a need for it to function, then why should our doses be lowered so we go back to debilitating pain? It’s hard enough as it is living with chronic pain & RA, & now with all these articles everywhere we have to worry about the relief we do get from opiates to be taken from us. Yeah, it is scary & like Elizabeth said, if these people publishing these articles, the CDC, the researchers, & the doctors were living with chronic debilitating pain they would have studies that figure out the REAL issue as to why these patients overdosed, instead of the easy fix to just take it from those that need it. Lowering the doses isn’t going to stop the people who abuse it.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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