{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T06:28:08Z","timestamp":1782368888247,"version":"3.54.5"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA047537"],"award-info":[{"award-number":["R01DA047537"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tapering long-term opioid therapy is an increasingly common practice, yet rapid opioid dose reductions may increase the risk of overdose. The objective of this study was to compare overdose risk following opioid dose reduction rates of \u226410%, 11% to 20%, 21% to 30%, and &gt;30% per month to stable dosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study in three health systems in Colorado and Wisconsin. Participants were patients \u226518\u2009years of age prescribed long-term opioid therapy between January 1, 2006, and June 30, 2019. Five opioid dosing patterns and drug overdoses (fatal and nonfatal) were identified using electronic health records, pharmacy records, and the National Death Index. Cox proportional hazard regression was conducted on a propensity score-weighted cohort to estimate adjusted hazard ratios (aHRs) for follow-up periods of 1, 3, 6, 9, and 12\u2009months after a dose reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In a cohort of 17\u2009540 patients receiving long-term opioid therapy, 42.7% of patients experienced a dose reduction. Relative to stable dosing, a dose reduction rate of &gt;30% was associated with an increased risk of overdose and the aHR estimates decreased as the follow-up increased; the aHRs for the 1-, 6- and 12-month follow-ups were 5.33 (95% CI, 1.98-14.34), 1.81 (95% CI,1.08-3.03), and 1.49 (95% CI, 0.97-2.27), respectively. The slower tapering rates were not associated with overdose risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients receiving long-term opioid therapy exposed to dose reduction rates of &gt;30% per month had increased overdose risk relative to patients exposed to stable dosing. Results support the use of slow dose reductions to minimize the risk of overdose.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08897077231186216","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T04:46:47Z","timestamp":1694580407000},"page":"209-219","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Association Between Opioid Dose Reduction Rates and Overdose Among Patients Prescribed Long-Term Opioid Therapy"],"prefix":"10.1177","volume":"44","author":[{"given":"Jason M.","family":"Glanz","sequence":"first","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA"},{"name":"Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal J.","family":"Narwaney","sequence":"additional","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"McClure","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Rinehart","sequence":"additional","affiliation":[{"name":"Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority, Denver, CO, USA"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan A.","family":"Ford","sequence":"additional","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh P.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8862-8078","authenticated-orcid":false,"given":"Ingrid A.","family":"Binswanger","sequence":"additional","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA"},{"name":"Chemical Dependency Treatment Services, Colorado Permanente Medical Group, Aurora, CO, USA"},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"bibr1-08897077231186216","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"bibr2-08897077231186216","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7103a1"},{"key":"bibr3-08897077231186216","unstructured":"U.S. Department of Health and Human Services. Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid. 2019. 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