0
Editor's Correspondence |

Opioids and Dose-Related Deaths—Association or Causation?—Reply

Tara Gomes, MHSc; Muhammad M. Mamdani, PharmD, MA, MPH; Irfan A. Dhalla, MD, MSc; J. Michael Paterson, MSc; David N. Juurlink, MD, PhD
Arch Intern Med. 2011;171(18):1687-1689. doi:10.1001/archinternmed.2011.453.
Text Size: A A A
Published online

Extract

In reply

We believe Dr Williamson has misinterpreted some aspects of the methodology of our study and its findings. Dr Williamson states that an unadjusted analysis reveals no association between higher opioid dose categories and opioid-related mortality. This is incorrect. Although not reported in our published article,1 the association between dose and opioid-related mortality was consistent in our unadjusted conditional logistic regression model for the primary outcome (odds ratio, 2.32, 2.97, and 3.69 among those prescribed 50-99 mg of morphine equivalents per day [ME/d], 100-199 mg of ME/d, and ≥200 mg of ME/d, respectively, compared with the 1-19 mg of ME/d group; P < .001 for all comparisons). Although the 95% confidence intervals overlap between high and moderate dose categories, a clear and significant association between higher doses of opioids and opioid-related mortality is apparent in both unadjusted and adjusted models.

Topics

opioids

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

October 10, 2011
Owen Douglas Williamson, MBBS, FFPMANZCA
Arch Intern Med. 2011;171(18):1687-1689. doi:10.1001/archinternmed.2011.452.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Postoperative nausea and vomiting in pediatric anesthesia. Curr Opin Anaesthesiol 2014;():.doi:10.1097/ACO.0000000000000073.
Jobs
brightcove.createExperiences();