title: Increasing deaths from opioid analgesics in the United States: an evaluation in an interventional pain management practice.
abstract: OBJECTIVE
  To assess the prevalence of opioid-related deaths in patients in an interventional pain management tertiary referral center.
  
  
  METHODS
  Patient deaths from March 2003 to February 2007 were evaluated.
  
  
  RESULTS
  From March 2003 to February 2007, 2,179 patients were receiving opioids in 2003, 2,445 in 2004, 2,804 in 2005, and 2,965 in 2006, respectively. Overall, 86 percent of the patients were referred by a physician and 90 percent of patients received interventional techniques. There were a total of 91 deaths, of which 60 were categorized as natural deaths, 25 were characterized as accidental deaths, and 6 were characterized as suicidal. Of the 18 drug poisoning deaths, 5 deaths were positively related to prescription drugs, 7 deaths were probably related to prescription drugs, and 6 deaths had no relation to the prescription drugs provided. Total opioid-related deaths were 12 over this 4-year period with 0.46 in 2003, 2.04 in 2004, 2.85 in 2005, and 1.35 in 2006 per 1,000 population. In contrast, deaths definitely related to prescription opioids were 5 (0.92 per 1,000) over a period of 4 years. In the suicidal group, there were a significantly higher proportion of patients with generalized anxiety disorder.
  
  
  CONCLUSIONS
  In an interventional pain management practice (a tertiary referral center), the total prevalence of opioid-related deaths varied from 0.46 to 1.78 per 1,000 from 2003 to 2006 with a total of 12 deaths over a period of 4 years. The deaths definitely related to opioidprescriptions were 5 with a rate of 0 to 1.43 per 1,000 over a period of 4 years.
authors.affiliation: Pain Management Center of Paducah, KY, USA.
authors.forename: Kavita N
authors.initials: KN
authors.lastname: Manchikanti
authors.forename: Laxmaiah
authors.initials: L
authors.lastname: Manchikanti
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Damron
authors.forename: Vidyasagar
authors.initials: V
authors.lastname: Pampati
authors.forename: Bert
authors.initials: B
authors.lastname: Fellows
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000506:poisoning*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000401:mortality; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid