{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:26:10Z","timestamp":1781180770056,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["pericles.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>An apparently protective effect of opioid agonist treatment (OAT) on all\u2010cause and cause\u2010specific mortality risk has been widely reported. Non\u2010fatal overdose (NFO) often precedes subsequent drug\u2010poisoning deaths. We hypothesized that benzodiazepines, gabapentinoids, antipsychotics, antidepressants, Z\u2010drugs or opioids increase the NFO risk when co\u2010prescribed with OAT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases. The cohort was linked to Hospital Episode Statistics admitted patient care data (HES\u2010APC), neighbourhood\u2010 and practice\u2010level Index of Multiple Deprivation quintiles and mortality records from the Office for National Statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Primary care in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>We studied patients with opioid use disorder, aged 18\u201364 years, who were prescribed OAT (15155 methadone and 5743 buprenorphine recipients) between Jan 1, 1998, and Dec 31, 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The main outcome examined was NFO risk during co\u2010prescription of OAT with benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z\u2010drugs or opioids. Overdose was defined according to International Classification of Diseases codes from the HES\u2010APC data set. Negative binomial regression models were used to estimate weighted rate ratios (wRR) for NFO during co\u2010prescription of OAT and benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z\u2010drugs or opioids with periods of exclusive OAT usage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Among 20\u2009898 patients observed over 83\u2009856 person\u2010years, we found an elevated overdose risk that resulted in hospital admission during co\u2010prescription of OAT with benzodiazepines [wRR: 1.45; 95% confidence interval (CI)\u2009=\u20091.26\u20131.67], gabapentinoids (wRR\u2009=\u20092.22; 95% CI\u2009=\u20091.77\u20132.79), Z\u2010drugs (wRR\u2009=\u20091.60; 95% CI\u2009=\u20091.31\u20131.96), antipsychotics (wRR\u2009=\u20091.85; 95% CI\u2009=\u20091.53\u20132.25) and opioids (wRR\u2009=\u20091.28; 95% CI\u2009=\u20091.02\u20131.60). The risk ratio for antidepressant co\u2010prescriptions was below unity (wRR\u2009=\u20090.90; 95% CI\u2009=\u20090.79\u20131.02) but this result was not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated risk of non\u2010fatal overdose among opioid agonist treatment recipients is associated with concurrent use of medication prescribed for other reasons.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16306","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:01:05Z","timestamp":1691107265000},"page":"2374-2383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Non\u2010fatal overdose risk associated with prescribing opioid agonists concurrently with other medication: Cohort study conducted using linked primary care, secondary care and mortality records"],"prefix":"10.1111","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-1288","authenticated-orcid":false,"given":"Eleni","family":"Domzaridou","sequence":"first","affiliation":[{"name":"National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre University of Manchester Manchester UK"},{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Carr","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre University of Manchester Manchester UK"},{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Millar","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger T.","family":"Webb","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre University of Manchester Manchester UK"},{"name":"Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren M.","family":"Ashcroft","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre University of Manchester Manchester UK"},{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32229-9"},{"key":"e_1_2_10_3_1","unstructured":"Office for National Statistics.Deaths related to drug poisoning in England and Wales: 2020 registrations.2021. 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