People receiving their first opioid prescription were propensity matched to people receiving NSAIDS (and, in sensitivity analysis, gabapentinoids) and the risk of death and hospitalization were compared, classifying opioid medication exposure as time-varying daily oral morphine milligram equivalents (MMEs) across time-varying eGFR.
Prescriptions for 1–59 and ≥60 MMEs were associated with higher risk of death .. and hospitalization.. compared with NSAID prescriptions, when evaluated at eGFR 80 ml/min per 1.73 m2. The relative risk of death associated with ≥60 MMEs was higher at lower GFR .. When gabapentinoids were used as the comparison medication, only ≥60 MMEs were significantly associated with higher risk of death (HR, 2.72; 95% CI, 1.71 to 4.34), although both 1–59 and ≥60 MMEs were associated with risk of hospitalization..
Conclusions The receipt of prescription opioids was associated with a higher risk of death and hospitalization compared with other pain medications, particularly with higher doses and at lower eGFR