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Table 4 Risk markers and outcomes of studies evaluating prescription drug overdose

From: Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis

First author, year Risk markers and exposures assessed Outcome Sample size
Bauer et al. 2016 Age, sex, race/ethnicity, veteran, location of death, autopsy performed Drug overdose death 28,033
Bohnert et al. 2011 a Sex, age, race, clinical diagnoses, comorbid conditions, as well as opioid dose and schedule Unintentional prescription opioid overdose (ICD-10 X42, X44, Y12 or Y14 in combination with T40.2) 155,434
Bohnert et al. 2012 a Sex, age, Charlson comorbidities, psychiatric diagnoses, substance use disorders, alcohol use disorders, other specific drug use or mental health disorders Death by accidental medication overdose was an accidental death with an underlying cause of death coded as ICD-10 codes X40-X45 due in part or whole to prescription or over the counter medications (ICD-10 codes T36.0-T39.9, T40.2-T40.4, and T42.0-T50.9) 3,291,891
Brady et al. 2015 ED utilization, age, sex, race, clinical characteristics Prescription drug overdose death 5464
Caudarella et al. 2016 Age, gender, ethnicity, homelessness, incarceration, daily cocaine injection, daily heroin injection, daily crack smoking, methadone maintenance treatment, HIV serostatus, and HCV serostatus Overdose mortality 2317
CDC Medicaid. 2009 Sex, age, Medicaid A Washington state resident whose death certificate had a manner of death listed as “accidental” or “natural” and one or more contributing causes coded as ICD-10 (T40.0-T40.6 and F11) and specific words compatible with acute drug intoxication recorded in any death field and a prescription opioid in any of the cause of death fields 6,321,950
CDC Non-illicit Drugs Utah 2005 b Sex, age, area of residence Non-illicit drug poisoning death 2,281,235
CDC Prescription opioid pain relievers. 2011 Sex, age, race Prescription drug overdose deaths (with underlying causes of deaths listed as ICD-10 codes X40-X44, X60-X64, X85 or Y10-Y14 and having T36-T39, T40.2-T40.4, T41-T43.5, and T43.7-T50.8) as contributing causes 304,093,966
CDC Urbanization, New Mexico, 2005 Urbanization Unintentional poisoning deaths from prescription drugs (i.e. methadone, other opioid painkiller, tranquillizer/muscle relaxant, antidepressant, barbiturate, or other prescription drug) 17,919,059
Cerdá et al. 2013 Sex, age, race Analgesic overdose fatalities (ICD-10 X40-X44, T40.0-T40.2) 3883
Coben et al. 2010 Sex and age Hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers (ICD-9965.02, 965.09, 965.5, 965.8, 967.0, 969.4, 969.5, 967.8, and 967.9.) Poisonings were classifıed as unintentional if there was an E-code present in the E850–E858 range (accidental poisonings by drugs, medicinal substances, and biologicals) 39,450,216
Dilokthornsakul et al. 2016 Sex, age, mean morphine dose equivalents, methadone use, chronic opioid use, pain diagnosis, comorbidities, history of other medication use ≥1 medical claim for an emergency department visit or a hospitalization associated with an opioid overdose 3264
Dunn et al. 2010 Sex, age, history of depression, history of substance abuse, opioid dose, any opioid use Opioid-related overdose death, or non-fatal event defined as definite or probable opioid-related overdose 9940
Gomes et al. 2011 c No. of pharmacies dispensing opioids, daily dose of opioids (>200 mg MME) Opioid-related death 2212
Hall et al. 2008 Sex, age, marital status and highest education Unintentional drug overdose deaths that involved prescription pharmaceuticals. This excluded those overdoses due solely to illicit drugs, over-the-counter products, or alcohol. 182,170
Hartung et al. 2007 Type of long acting opioid (Methadone, Oxycodone, Fentanyl, Morphine) Administrative claims for an opioid-related serious adverse event, ED encounter or hospitalization for opioid-related adverse event (CPT code 99281-99285 or 99,288 or ED revenue center codes of 45× or 981 with ICD-9965.0×), opioid poisoning (ICD-9965.0×), or overdose symptoms (ICD-9 codes 780.0×, 78.07×, 418.81, 518.82, 564.0×) 5684
Havens et al. 2011a Sex, age, race, psychiatric comorbidities, substance use Non-fatal overdose 400
Hulse et al. 2001 Sex Hospitalization for prescription /over the counter drugs 160
Lanier et al. 2012 Sex, age, race, marital status, body mass index, uninsured, education, employment status, smoking status, residence in an urban county, military service Death from prescription opioids 1562
Mack 2013 Age and race Prescription drug overdose deaths (with underlying causes of deaths listed as ICD-10 codes X40-X44, X60-X64, X85 or Y10-Y14 and having T36-T39, T40.2-T40.4, T41-T43.5, and T43.8-T50.8) as contributing causes 157,237,928
Paulozzi et al. 2012 Sex, age, prescription history Death from unintentional drug overdose 6293
Peirce et al. 2012 Prior doctor and or pharmacy shopping Controlled substance-related death 1,049,903
Piercefield et al. 2010 d Sex, age, race and urban/rural Medication overdose deaths 3,540,517
Rudd et al. 2016 Sex, age, race Prescription drug overdose deaths (with underlying causes of deaths listed as ICD-10 codes X40-X44, X60-X64, X85 or Y10-Y14 and having T36-T39, T40.2-T40.4, T41-T43.5, and T43.7-T50.8) as contributing causes 641,538,924
Seal et al. 2012 a Opioid use, post-traumatic stress disorder (PTSD), PTSD with or without other mental health disorders Opioid-related accidents and overdoses (ICD-9 codes: 965.00, 965.01, 965.02,965.09, E850.0, E850.1, E850.2, E935.0, E935.1, and E935.2) 141,030
Silva et al. 2013 Sex, race, psychiatric care, substance use Non-fatal overdose on prescription opioids and/or tranquilizers 596
Turner and Liang 2015 Sex, age, US region, clinical conditions, mental health and substance use disorders, Any drug overdose event 206,869
Whitmire and Adams 2010 d Eligibility category, race, residence, specific disorders, drug claims Unintentional overdose death (ICD-10 X40-X49) 2801
Zedler et al. 2014 Age, sex, race/ethnicity, marital status, BMI, US Census region, comorbidities, opioid use, all-cause health care utilization (ED visits) Occurrence of serious opioid-related toxicity or overdose as defined by listed ICD-9-CM and CPT codes 8987
  1. MMEs morphine milligram equivalents, CPT current procedural terminology, ICD-9 international classification of diseases, 9th revision, ICD-10 international classification of diseases, 10th revision, CS controlled substances, OME office of the medical examiner
  2. aStudies are not independent
  3. bInformation refers to deaths occurring between 1999 and 2003
  4. cInformation refers to deaths occurring between 2004 and 2006
  5. dMatching variables not included in risk markers