A new study led by a McMaster researcher identifies 10 predictors that show large associations with opioid overdose.

The predictors were identified as part of a large-scale study published this week in the Canadian Medical Association Journal (CMAJ).

An awareness of these predictors can help the public and providers better understand the risks of overdose when deciding whether opioids should be used for chronic pain, says  lead author Li Wang, an associate professor with McMaster’s department of Anesthesia, and a researcher and methodologist at the Michael G. DeGroote Institute for Pain Research and Care.

“The opioid crisis has generated interest in identifying patients at higher risk of addiction or overdose and led to the development of several screening tools,” Wang says.

“However, these instruments have either not been validated or shown poor validity and reliability.”

The study found the risk of opioid overdose — both fatal and nonfatal — after prescription was two to six times higher with high-dose opioids, fentanyl prescription, multiple opioid prescribers or pharmacies, a history of overdose, current substance use disorder, depression, bipolar disorder, other mental illness, or pancreatitis.

“Our findings suggest that awareness of, and attention to, several patient and prescription characteristics, may help reduce the risk of opioid overdose among people living with chronic pain.”

As part of their work, researchers examined 28 studies that included 24 million patients from Canada, the United Kingdom and the United States. The patients had been prescribed opioids for non-cancer and cancer-related chronic pain.

The study, published Oct. 23, was funded in part by a grant from Health Canada’s Substance Use and Addictions Program.