Table 2:
Number and percent of people with a fatal or non-fatal suicide event, fatal or non-fatal opioid overdose, opioid-related adverse event, or buprenorphine fill in 12 months after discontinuation or dose reduction according to opioid dose trajectory*
| Total | Abrupt discontinuation | Dose reduction and discontinuation | Dose reduction without discontinuation | Stable or increasing dose | p-value | |
|---|---|---|---|---|---|---|
| N (%) | 14,596 | 4,191 (28.7%) | 1,648 (11.3%) | 6,480 (44.4%) | 2,277 (15.6%) | |
| Median days between end of COT and start of follow-up | 8 | 29 | 23 | 30 | 0 | |
| Any opioid-related event** | 625 (4.3%) | 222 (5.3%) | 101 (6.1%) | 220 (3.4%) | 82 (3.6%) | <0.0001 |
| Suicide | 88 (0.6%) | 40 (1.0%) | 23 (1.4%) | 20 (0.3%) | 5 (0.2%) | <0.0001 |
| Fatal | 31 (35.2%) | 23 (57.5%) | 3 (13.0%) | 5 (25.0%) | 0 (0.0%) | <0.0001 |
| Non-fatal | 57 (64.8%) | 17 (42.5%) | 20 (87.0%) | 15 (75.0%) | 5 (100.0%) | |
| Opioid Overdose | 156 (1.1%) | 54 (1.3%) | 15 (0.9%) | 47 (0.7%) | 40 (1.7%) | 0.0002 |
| Fatal | 42 (26.9%) | 11 (20.4%) | 2 (13.3%) | 2 (4.3%) | 27 (67.5%) | <0.0001 |
| Non-fatal | 114 (73.1%) | 43 (79.6%) | 13 (86.7%) | 45 (95.7%) | 13 (32.5%) | |
| Heroin | 14 (9.0%) | 8 (14.8%) | 1 (6.7%) | 2 (4.3%) | 3 (7.5%) | 0.0622 |
| Rx Opioid | 142 (91.0%) | 46 (85.2%) | 14 (93.3%) | 45 (95.7%) | 37 (92.5%) | |
| Other Opioid-related Harms | 462 (3.2%) | 160 (3.8%) | 76 (4.6%) | 182 (2.7%) | 44 (1.9%) | <0.0001 |
| Adverse Effects | 32 (6.9%) | 9 (5.6%) | 3 (3.9%) | 16 (8.8%) | 4 (9.1%) | 0.9117 |
| Opioid Abuse | 60 (13.0%) | 33 (20.6%) | 11 (14.5%) | 12 (6.6%) | 4 (9.1%) | <0.0001 |
| Opioid Dependence | 361 (78.1%) | 177 (73.1%) | 12 (6.6%) | 149 (81.9%) | 36 (81.8%) | <0.0001 |
| Opioid Use, Unspecified | 9 (1.9%) | 1 (0.6%) | 4 (9.1%) | 5 (2.8%) | 0 (0.0%) | 0.0173 |
| Buprenorphine Filled | 327 (2.2%) | 192 (4.6%) | 83 (5.0%) | 46 (0.7%) | 6 (0.3%) | <0.0001 |
Some patients had more than one outcome event, so are counted once in each event type category. For example, an individual with a non-fatal overdose and an opioid abuse indicator would be counted twice, once in each category. Where a patient experienced multiple events of the same type (e.g. multiple non-fatal Rx Opioid overdoses) they are counted once; if multiple events within a category differed, the more severe event was counted (e.g. an individual with a prescription overdose and heroin overdose would be counted once in the heroin category).
Any opioid-related event flags whether a patient had any of the events regardless of the count.