{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T21:23:22Z","timestamp":1773350602613,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,9,20]],"date-time":"2020-09-20T00:00:00Z","timestamp":1600560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Australian Government Department of Health under the Drug and Alcohol Program"},{"name":"Queensland Centre for Mental Health Research, which receives core funding from the Department of Health, Queensland Government"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"crossref","award":["GNT1140938"],"award-info":[{"award-number":["GNT1140938"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"crossref","award":["GNT1135991"],"award-info":[{"award-number":["GNT1135991"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institutes of Health, National Institute on Drug Abuse","award":["R01DA1104470"],"award-info":[{"award-number":["R01DA1104470"]}]},{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"publisher","award":["GNT1104600"],"award-info":[{"award-number":["GNT1104600"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHMRC Fellowship","award":["GNT1109366"],"award-info":[{"award-number":["GNT1109366"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate all-cause and overdose crude mortality rates and standardized mortality ratios among people prescribed opioids for chronic noncancer pain and risk of overdose death in this population relative to people with similar clinical profiles but not prescribed opioids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Systematic review and meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medline, Embase, and PsycINFO were searched in February 2018 and October 2019 for articles published beginning 2009. Due to limitations in published studies, we revised our inclusion criteria to include cohort studies of people prescribed opioids, excluding those studies where people were explicitly prescribed opioids for the treatment of opioid use disorder or acute cancer or palliative pain. We estimated pooled all-cause and overdose crude mortality rates using random effects meta-analysis models. No studies reported standardized mortality ratios or relative risks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 13 cohorts with 6,029,810 participants. The pooled all-cause crude mortality rate, based on 10 cohorts, was 28.8 per 1000 person-years (95% CI = 17.9\u201346.4), with substantial heterogeneity (I2 = 99.9%). The pooled overdose crude mortality rate, based on six cohorts, was 1.1 per 1000 person-years (95% CI = 0.4\u20133.4), with substantial heterogeneity (I2 = 99.5%), but indications for opioid prescribing and opioid exposure were poorly ascertained. We were unable to estimate mortality in this population relative to clinically similar populations not prescribed opioids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Methodological limitations in the identified literature complicate efforts to determine the overdose mortality risk of people prescribed opioids. There is a need for large-scale clinical trials to assess adverse outcomes in opioid prescribing, especially for chronic noncancer pain.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa214","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T19:12:47Z","timestamp":1590693167000},"page":"3700-3711","source":"Crossref","is-referenced-by-count":16,"title":["All-Cause and Overdose Mortality Risk Among People Prescribed Opioids: A Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"21","author":[{"given":"Sarah","family":"Larney","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Universit\u00e9 de Montr\u00e9al and Centre de Recherche du Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CR-CHUM), Montreal, Quebec, Canada"},{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy T","family":"Tran","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Stockings","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Santomauro","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Queensland, Brisbane, Queensland, Australia"},{"name":"Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia"},{"name":"Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Thomas","family":"Santo","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; \u2021School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,20]]},"reference":[{"key":"2020122823520507700_pnaa214-B1","volume-title":"WHO Model List of Essential Medicines","year":"2005","edition":"14th ed."},{"issue":"4","key":"2020122823520507700_pnaa214-B2","doi-asserted-by":"crossref","first-page":"276","DOI":"10.7326\/M14-2559","article-title":"The effectiveness and risks of long-term opioid therapy for chronic pain: A systematic review for a National Institutes of Health Pathways to Prevention Workshop","volume":"162","author":"Chou","year":"2015","journal-title":"Ann Intern Med"},{"issue":"15","key":"2020122823520507700_pnaa214-B3","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2016.1464","article-title":"CDC guideline for prescribing opioids for chronic pain-United States, 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